Before Surgery

Once your surgery is scheduled, your surgeon’s office should communicate to you instructions on how to prepare for your specific procedure, including required preoperative testing, consultation with other physicians, medications to take or avoid in the days leading up to surgery, and items to bring on the day of surgery.

A nurse from the operating facility will also contact you 1 to 2 days prior to the day of surgery to review your medical history, medications to continue/discontinue, and the logistics of the day, including when to arrive, where to go, and what to expect.   Finally, the evening before surgery, your anesthesiologist may call you to, once again, review all of the above and give you specific instructions on how to prepare for your surgery, as it applies to your anesthetic care.  Some of this may seem redundant and it may seem like you’re answering the same questions over-and-over, but this process allows us to confirm and make certain that all your information is correct and that nothing is overlooked. A complete and accurate assessment of your medical history allows us to provide a safe and effective anesthetic.  

A critical component of your preparation for surgery is your NPO status (“nil per os;” nothing by mouth).  Prior to surgery, you should be fasting from all foods and drinks.  The reason for this is that when under anesthesia, there is an increased risk of regurgitating the contents of your stomach into your lungs, leading to a very serious condition called aspiration pneumonitis or aspiration pneumonia. Please see below for a chart of when you should stop consuming the different types of foods and drinks.  In addition to fasting from foods and drinks, you should not chew gum or take any candies/lozenges on the day of your surgery.  Finally, with the exception of any blood thinners/anticoagulants or any specific medications your surgeon or anesthesiologist has instructed you to avoid, you may continue to take all your medications as you normally do, even on the morning of surgery.  When taking these medication, please be sure to drink as little water as possible.

Injested Material Minimum Fasting Period
Clear liquids* 2 hours
Breast milk 4 hours
Infant formula 6 hours
Nonhuman milk 6 hours
Light meal** 6 hours
Fried foods, fatty foods, or meat Additional fasting time (e.g. 8 hours or more) may be needed
*As a general rule of thumb, a clear liquid is any liquid you can see through (e.g., apple juice and Gatorade)
**A light meal typically consists of toast and clear liquids.  Meals that include fried or fatty foods or meat may prolong gastric emptying time. Additional fasting time (e.g., 8 or more hours) may be needed in these cases.   Both the amount and type of food ingested must be considered when determining an appropriate fasting period.

On the day of surgery, you will meet your anesthesiologist in the preoperative area, where he/she will, once again, review your medical history, perform an examination, and review your anesthetic plan with you.  Assessment of your airway is an important part of the examination, and may involve inspecting your mouth opening, evaluation of your dentition (please be sure to mention any removable dentures, dental crowns, loose and/or chipped teeth and caps), and checking your neck range of motion.  This is an important time to mention any problems with anesthesia in the past, including a history of malignant hyperthermia, previous difficult intubations, history of awareness under anesthesia, nausea after surgery, or unintended admissions into a hospital after surgery.  Based on your specific health needs and your particular procedure, your anesthesiologist will then formulate the safest anesthetic plan to comfortably get you through your surgery.