Avoiding Food and Drink: The Critical Fasting Rule
For most surgeries, one of the most critical instructions is to stop eating and drinking at a specific time, usually beginning at midnight the night before the procedure. Anesthesia can relax your body's reflexes, and if there is food or liquid in your stomach, it could enter your lungs, leading to a serious and potentially fatal condition called aspiration pneumonia [2]. This is why following these instructions is non-negotiable.
Why Fasting is So Important
- Prevents Aspiration: The primary reason for fasting is to prevent pulmonary aspiration, where stomach contents are accidentally inhaled into the lungs while you are under anesthesia.
- Reduces Nausea: A full stomach can increase the likelihood of post-operative nausea and vomiting.
- Ensures Anesthesia Safety: Fasting ensures a safe environment for the anesthesiologist to administer medication without undue risk.
What to Avoid Consuming
- Solid Foods: No food after midnight. This includes even small snacks, candy, or mints.
- Alcohol: Avoid alcohol for at least 24 hours before your procedure, as it can interact with anesthesia and increase bleeding risks [3].
- Certain Liquids: Follow your doctor's specific guidance on liquids. While some clear liquids may be allowed up to a few hours before, milk and other non-clear drinks are typically forbidden [4].
Medication Management: Not All Pills Are Safe
Taking your usual medications requires careful attention and explicit direction from your doctor. Many over-the-counter and prescription drugs can interfere with anesthesia, clotting, or the surgical outcome itself.
Medications and Supplements to Discontinue
- Blood Thinners: Medications like aspirin, NSAIDs (e.g., ibuprofen, naproxen), and herbal supplements (ginkgo, fish oil) must often be stopped several days in advance due to their effect on blood clotting [5, 3].
- Herbal Supplements: Many herbal remedies, including ginseng and St. John's Wort, can have complex interactions with anesthesia or affect bleeding [1].
- Some Diabetes Medication: Your doctor will provide specific instructions for insulin or oral diabetes medication, as fasting affects your blood sugar [6].
- Vitamins: The American Society of Anesthesiologists suggests stopping all herbal and some vitamin supplements weeks before surgery [1].
Always Confirm with Your Care Team
Do not assume which medications are safe. Always review your entire medication list—including prescriptions, over-the-counter drugs, and supplements—with your surgeon and anesthesiologist. They will provide a specific plan detailing which to take and which to skip.
Personal Care and Grooming Mistakes
Beyond what you ingest, certain personal grooming habits can pose risks in the operating room. Preparing your body properly helps reduce the risk of infection and allows the medical team to monitor your health effectively.
Grooming Activities to Avoid
- Shaving Near the Surgical Site: Do not shave the surgical area for at least 24 hours prior to surgery. Nicks and cuts can increase the risk of infection [2].
- Wearing Makeup, Lotion, or Nail Polish: Make-up and lotions can harbor bacteria. Nail polish can hide the natural color of your nail bed, which is a crucial indicator of your oxygen levels monitored by medical staff [1].
- Wearing Jewelry and Piercings: Metal jewelry can interfere with electro-surgical equipment. All piercings must be removed [1].
- Hairspray or Hair Pins: Avoid these as they can be flammable and interfere with monitoring equipment [1].
Table: Pre-Surgery Do's and Don'ts
| Category | Do | Don't |
|---|---|---|
| Food & Drink | Follow fasting instructions precisely. Drink clear liquids only as directed. | Eat solid food, chew gum, or have milk after midnight (or other specified time). |
| Medications | Take only medications your doctor approved with a small sip of water. | Take aspirin, blood thinners, or herbal supplements unless approved. |
| Personal Care | Shower or bathe with antibacterial soap as instructed. Wear loose, comfortable clothing. | Shave the surgical area, wear makeup, lotion, or nail polish. |
| Valuables | Leave all valuables, including jewelry and credit cards, at home. | Bring money, expensive jewelry, or other valuables to the hospital. |
| Lifestyle | Rest, hydrate (if permitted), and prepare for your recovery. | Drink alcohol, smoke, or engage in heavy exercise for 24+ hours prior. |
Mental and Physical Readiness
Preparing for surgery is not just a physical process; it is also a mental one. Stress and anxiety can affect your recovery. Avoid making major decisions, engaging in stressful activities, or not arranging for proper post-op care.
Prepare for Your Recovery
- Arrange Transportation: Ensure a responsible adult can drive you home. Many facilities will cancel your surgery if you don't have a ride [7].
- Secure Childcare or Pet Care: Make arrangements for dependents so you can focus on your recovery.
- Avoid Important Decisions: Anesthesia can impair judgment for up to 24 hours. Postpone signing legal documents or making important decisions [7].
- Stop Smoking: Smoking significantly hinders wound healing and can cause respiratory complications during and after surgery. Quitting well in advance is highly recommended, but stopping at least 24 hours beforehand is mandatory [5].
A Note on Illness and Pre-existing Conditions
Do not hesitate to call your surgeon's office if you feel unwell, even with minor symptoms. Illnesses like a cold, fever, or sore throat can cause your procedure to be postponed [8]. Your doctor needs a complete picture of your health to proceed safely. Always provide a full health history, including any family history of anesthetic complications or other relevant conditions [1]. For comprehensive information on surgical safety, refer to the American Society of Anesthesiologists.
Conclusion: Prioritize Safety Above All Else
Your actions the day before surgery directly impact the safety and success of your procedure. By meticulously following your healthcare team's instructions—especially regarding fasting, medication, and personal care—you minimize risks and set yourself up for a smoother recovery. The simple step of being prepared and communicating openly with your medical team is your best tool for a positive surgical outcome.
