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Preparing for Surgery

HOW CAN YOU HELP prior to your surgery?

  1. Bring all of your current medications to orientation for review.
  2. Consult your physician for special instructions if you are taking routine medications, insulin, or blood thinners.
  3. Do not eat or drink anything for at least eight hours before your scheduled surgery. Do not chew gum or use any tobacco products.
  4. Shower or bathe to minimize the chance of infection and wear loose, comfortable clothing. BATHING INSTRUCTIONS
  5. Leave jewelry and other valuables at home.
  6. Take out removable teeth prior to transfer to the operating room and do not wear glasses or contact lenses in the OR.
  7. If you are a Same Day Surgery patient, arrange for a responsible adult to drive you home and to provide care for at least 24 hours.
  8. If you are a smoker, we recommend that you stop smoking at least two weeks prior to your surgery
  9. If you have had any problems with anesthetics in the past, please discuss this with your surgeon so that your anesthesia provider is aware of this prior to your procedure.
  10. If you are currently using a CPAP machine for sleep apnea, please bring the machine with you the day of surgery.

Frequently asked questions before surgery

Q. What can I eat and drink before surgery?
A. You may not eat or drink anything for eight hours before surgery with the exception of some (but not all) medications. Caution: Eating too close to your scheduled surgery may require rescheduling of your surgery.

Q. What tests do I need before surgery?
A. Required tests may include blood work, heart testing (EKG) or x-rays. Your primary care physician should have these ordered during your pre-op visit. All tests need to be done within 30 days of your procedure.

Q. Why do I need to have pre-operative testing?
A. Test results can play a role in the selection of anesthetic techniques (e.g., regional anesthesia in the setting of anticoagulation therapy) and they help the anesthesiologist make clinical judgment based on your most recent health status.

Q. What medications should I STOP before surgery?
A.

  • Anticoagulants (blood thinners) usually need to be stopped several days before surgery. Oral medications may need to be replaced with injected or intravenous (IV) medications. It is extremely important that both your surgeon and your physician (who has ordered the anticoagulants) discuss the optimum timing for stopping these medicines. Please be aware that many drugs and herbal products may be anticoagulants (blood thinners) although they are not used for that purpose.

    Prescription anticoagulants include:
    • warfarin (Coumadin)
    • enoxaparin (Lovenox)
    • clopidogrel (Plavix)
    • ticlopidine (Ticlid)
    • aspirin (in many versions)
    • non-steroidal anti-inflammatory (NSAIDs) (in many versions)
    • dipyridamole (Persantine)
    • aledronate (Fosamax)

    Non-prescription (over-the counter or herbal) anticoagulants include:

    • Aspirin (in many versions)
    • non-steroidal anti-inflammatory (NSAIDs) (in many versions)
    • Vitamin E
    • garlic
    • ginger
    • ginkgo biloba
    • No regional anesthesia can be given in the setting of anticoagulant therapy.
  • Monoamine Oxidase Inhibitors (MAOIs): Drugs in this group include some anti-depressants and most anti-Parkinson drugs. MAOIs can interfere with many of the medications used during anesthesia. If the medication needs to be stopped, it should be done one to two weeks (7-14 days) before surgery because it takes that long for the drug to be out of your system. You should discuss this with your surgeon and primary physician as early as possible.

    MAOIs include:
    • tranylcypromine (Parnate, Sicoton)
    • phenelzine (Nardil, Nardelzine)
    • isocarbonazid (Marplan)
    • rasagiline (Azilect)
    • selegiline (Eldepryl, Deprenyl)
    • linezolid (Zuvox) (an antibiotic)
    • St. John’s Wort

Q. What medications may I take on the day of surgery?
A. In general, blood pressure (heart) medications, anti-seizure medications and acetaminophen-containing pain medications (no aspirin or NSAIDs) should be taken the morning of surgery with a sip of water. Insulin may be given in a reduced dose. Discuss this with your anesthesiologist. Oral hypoglycemic (diabetes pills) should NOT be taken.

Q. What if I use a CPAP machine at home for sleep apnea?
A. Bring your machine with you on the day of surgery. We will most likely have you use it while you are recovering from the medications you receive.

Q. What if I have a pacemaker or internal defibrillator?
A. Make sure that you inform your surgeon and anesthesiologist that you have the device and bring the information card from your device (brand & model, company contact info). Each device responds differently to the devices we use in the operating room. We may need to have the device interrogated (tested) before or after your surgery, usually within six months of surgery.

Q. Can I request a particular anesthesiologist?
A. We are happy to accommodate requests when possible. However, not all of our physicians are available every day. Please contact our scheduler at 410-730-0099 to make a request or if you have any anesthesia-related questions.


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