Avoiding Food and Drink
For many surgeries requiring general anesthesia, the most important instruction is to not eat or drink anything after midnight. This fasting period is a critical safety measure that reduces the risk of aspiration pneumonia, a dangerous condition where stomach contents enter the lungs. The stomach needs to be completely empty for anesthesia to be administered safely. Even small sips of water, chewing gum, or a mint can pose a risk. If your surgeon provides specific instructions regarding a different fasting period, always follow their guidance precisely. For certain procedures or patients, a clear liquid diet may be permitted for a longer duration, but this is an exception, not the rule. The night before, a light, healthy meal is usually fine, but it should be consumed well before the designated cutoff time. After that, nothing, not even a single sip of water, should pass your lips.
The Dangers of Aspiration Pneumonia
During general anesthesia, your body's protective reflexes, including the one that prevents you from breathing in foreign objects, are temporarily suppressed. If there is food or liquid in your stomach, there is a risk of it coming up and entering your lungs. Aspiration pneumonia can lead to severe respiratory distress and prolong your hospital stay, making adherence to fasting instructions non-negotiable for patient safety.
Refrain from Alcohol and Tobacco
Both alcohol and tobacco use can have significant, negative impacts on your surgical outcome. The night before surgery is a time to prioritize your health, not indulge in vices. Alcohol can interfere with anesthesia medications and blood clotting, increasing the risk of bleeding. It can also cause dehydration and can affect your liver's ability to metabolize anesthetic drugs, potentially leading to complications.
Similarly, smoking is highly discouraged. Patients who smoke tend to have more respiratory complications during and after surgery. Smoking can lead to issues with breathing under anesthesia and impairs the body's ability to heal post-operation. Quitting smoking in the weeks leading up to surgery is ideal, but at a minimum, you must not smoke the night before or the morning of the procedure. For those who smoke regularly, the surgical team may discuss nicotine replacement therapy to help manage withdrawal, though quitting entirely is the safest option.
Medications and Supplements to Avoid
Many medications and supplements need to be stopped in the days or weeks leading up to surgery, and the night before is no exception. It is crucial to follow your doctor's specific instructions regarding your medication regimen. Certain medications, particularly blood thinners like aspirin, ibuprofen (Advil, Motrin), and other NSAIDs, must be stopped well in advance to prevent excessive bleeding during the operation. Even seemingly harmless herbal supplements, such as ginkgo biloba, ginseng, and vitamin E, can increase bleeding risks. It's important to create a comprehensive list of all medications, vitamins, and supplements you take and review it with your surgical team.
Comparison of Medication Guidelines
| Type of Medication | When to Stop (Typically) | Why It's Necessary |
|---|---|---|
| Blood Thinners (Aspirin, Warfarin) | Days to Weeks Prior | Increases risk of bleeding |
| Herbal Supplements (Ginseng, Ginkgo Biloba) | At Least 1 Week Prior | Can affect blood clotting and interact with anesthesia |
| NSAIDs (Ibuprofen, Naproxen) | Days to Weeks Prior | Can increase bleeding risk |
| Prescription Medications | Follow Doctor's Order | Based on drug type and your specific health history |
| Vitamins (especially E) | At Least 1 Week Prior | Affects blood clotting |
Leave Valuables, Makeup, and Nail Polish at Home
To prepare for surgery, you will need to remove all jewelry, including wedding rings and body piercings. These items can pose a risk during surgery, as they can cause burns from the electrocautery devices used in the operating room. Valuables like credit cards, watches, and expensive belongings should be left at home to ensure they are not lost or damaged. You will be asked to change into a hospital gown, and the hospital cannot be held responsible for lost personal items.
Additionally, makeup, lotion, deodorant, and nail polish must be removed. Nail polish on your fingers or toes can interfere with a pulse oximeter, a device that clips onto a finger or toe to measure your blood oxygen levels. The device uses a light beam to read the color of the blood, and nail polish can obstruct this reading. Similarly, makeup and lotions can interfere with the adherence of monitoring pads and can harbor bacteria. Removing these items is a simple yet vital step in preparing for a safe procedure. For more information on general health and wellness, visit the National Institutes of Health.
Avoid Strenuous Activity and Stress
The night before surgery is not the time for a rigorous workout or a stressful, late-night project. Physical exertion can increase your heart rate and cause dehydration, neither of which is beneficial before surgery. Your body and mind need to be as calm and rested as possible. Focus on relaxation techniques, like deep breathing, light stretching, or listening to calming music. Try to get a good night's sleep to ensure you are well-rested. Stress and anxiety can also affect your blood pressure and overall health, so finding a way to relax is important. Trust that your medical team is prepared and that you have done everything necessary to prepare for a successful outcome.
Conclusion
To ensure a safe and successful surgery, it is essential to follow all pre-operative instructions precisely. The night before surgery, this includes avoiding food and drink after midnight, abstaining from alcohol and tobacco, and following specific medication guidelines. Furthermore, removing all jewelry, makeup, and nail polish is necessary for patient safety and accurate monitoring. By avoiding these activities and preparing both your body and mind, you can significantly reduce risks and set yourself up for a smooth procedure and recovery.
