The Importance of Pre-Operative Instructions
Undergoing surgery, whether a minor outpatient procedure or a major hospital stay, requires careful preparation. Your medical team will provide you with specific instructions designed to maximize your safety and the procedure's success. These rules aren't arbitrary; they are based on medical evidence aimed at preventing complications like aspiration, excessive bleeding, or adverse reactions to anesthesia. Failing to follow these guidelines, even inadvertently, could lead to your surgery being postponed or, in rare cases, serious health issues.
Fasting: Why Nothing Means Nothing
One of the most fundamental rules before surgery is to refrain from eating or drinking. For many procedures, you will be instructed to have "nothing by mouth" (NPO) after a specific time, often after midnight the night before. This includes not only food but also water, chewing gum, hard candy, and mints. For some elective surgeries, you may be permitted to have clear liquids up to a couple of hours beforehand, but this is always under the direct guidance of your medical team.
The Dangers of Aspiration
The strict fasting rule is directly related to the use of anesthesia. While under anesthesia, your body's normal reflexes, including the gag reflex that protects your airway, are suppressed. If there is food or liquid in your stomach, it could be regurgitated and then accidentally inhaled into your lungs. This serious condition, known as aspiration, can cause pneumonia, lung damage, or other life-threatening respiratory complications. It's why this instruction is a non-negotiable part of pre-operative care.
Medications, Supplements, and Herbals to Stop
Medications and supplements can significantly interfere with anesthesia and surgical procedures. It is essential to provide your doctor with a complete list of everything you are taking, including prescriptions, over-the-counter drugs, vitamins, and herbal remedies. Your doctor will then tell you which ones to stop and when. You should never stop a prescription medication without your doctor's explicit approval.
A Comparison of Common Medications Before Surgery
| Medication Type | Examples | Reason to Stop | Stop Time (Consult Your Doctor) |
|---|---|---|---|
| Blood Thinners | Aspirin, Plavix, Warfarin | Increases risk of excessive bleeding | 5–10 days prior |
| NSAIDs | Ibuprofen, Naproxen, Aleve | Can increase bleeding; affects kidney function | 2–7 days prior |
| Herbal Supplements | Ginkgo, Ginseng, Vitamin E | Potential to increase bleeding or affect anesthesia | 7–14 days prior |
| Diabetes Medications | Insulin, Metformin | May require dose adjustments to manage blood sugar | The day of or day before |
| Antidepressants (MAOIs) | Phenelzine, Tranylcypromine | Risk of dangerous interactions with anesthesia | 2 weeks prior |
Herbal Supplements: A Hidden Risk
Many people believe that because a product is 'natural,' it is harmless. However, herbal supplements can pose significant risks in a surgical setting. For example, supplements like ginkgo biloba, garlic, and ginger can have blood-thinning properties. Others, such as St. John's Wort, can interfere with how your body processes other medications. For your safety, always disclose all supplements to your doctor, even those you consider minor.
Lifestyle Habits: Avoiding Smoking and Alcohol
Certain lifestyle choices can negatively impact your surgical outcome. Smoking and drinking alcohol are two of the most critical to avoid in the weeks and days leading up to your procedure.
The Impact of Tobacco Use
Smoking significantly increases the risk of complications. Nicotine restricts blood vessels, leading to poor circulation and oxygen delivery, which can delay wound healing and increase the risk of infection. Carbon monoxide from cigarettes reduces the oxygen-carrying capacity of your blood, putting a strain on your heart. Quitting smoking for as long as possible before surgery, ideally 4–6 weeks, can dramatically improve your outcome.
The Dangers of Alcohol Consumption
Excessive alcohol consumption before surgery can also be dangerous. Heavy drinking can affect your liver function, alter your body's ability to metabolize anesthesia, and increase your risk of bleeding. Alcohol withdrawal in heavy drinkers can also be a serious medical issue. It is typically recommended to stop drinking alcohol for at least 24 hours before surgery, with heavy drinkers often advised to stop weeks in advance.
Final Preparations: What to Avoid on Surgery Day
On the day of your surgery, there are specific things you must remember to leave at home or avoid entirely. These are for your safety and to ensure the medical team can properly monitor you.
Personal Care and Hygiene
- Do not wear makeup, nail polish, or fake nails. The natural color of your skin and nails is a critical indicator of your blood circulation. Medics monitor this closely, and cosmetic products can hide important warning signs.
- Do not apply lotions, deodorants, or creams. These can interfere with surgical tape, dressings, or the electrodes used for monitoring your heart and other vital signs.
- Do not use hair products. Hairspray, gels, and other flammable products should be avoided. Some facilities may even ask that you wash your hair the morning of the procedure.
Clothing, Jewelry, and Valuables
- Leave all jewelry at home. This includes rings, watches, necklaces, earrings, and all body piercings. They can cause injury during the procedure, and metal items can pose a risk during procedures involving electricity (electrocautery).
- Do not bring valuables. This minimizes the risk of losing important personal items.
- Wear loose, comfortable clothing. The clothes you wear should be easy to put on and take off. This helps with comfort and access for medical staff.
Conclusion: Prioritizing Your Safety
By following your medical team's specific pre-operative instructions, you take an active role in ensuring your safety and a successful procedure. From the critical fasting window to understanding which medications and habits to avoid, each step is a crucial component of proper surgical care. Always ask questions and clarify any uncertainty with your doctor. Your diligence in preparation, including knowing what should you not do before surgery, is one of the most important factors in achieving a positive outcome and swift recovery. For more comprehensive guidelines on preparing for surgery, you can find valuable information from authoritative sources like the American Society of Anesthesiologists.
