Essential Items to Discontinue Before Your Procedure
Undergoing surgery is a significant event that requires careful planning, and a major part of that is understanding which items to stop or avoid in the days and weeks leading up to your operation. Failing to follow these guidelines can increase the risk of complications, affect how your body responds to anesthesia, and delay your recovery. By being well-informed and working closely with your medical team, you can take control of your pre-operative preparation and contribute to a successful outcome.
Medications That May Affect Your Surgery
Many common medications, both prescription and over-the-counter, can pose risks during surgery. The specific timing for stopping each medication is critical and must be determined by your doctor. Never stop taking a prescribed medication without their explicit instruction.
Blood-Thinning Medications
- Why they are stopped: To minimize the risk of excessive bleeding during and after the procedure.
- Examples include: Warfarin (Coumadin), clopidogrel (Plavix), apixaban (Eliquis), rivaroxaban (Xarelto), and aspirin.
- Timeline: Often stopped anywhere from 3 to 10 days before surgery, depending on the medication and procedure. Your surgeon may provide a bridge therapy with a different anticoagulant if needed.
Non-Steroidal Anti-Inflammatory Drugs (NSAIDs)
- Why they are stopped: These medications can also thin the blood and increase bleeding risk.
- Examples include: Ibuprofen (Advil, Motrin), naproxen (Aleve), and celecoxib (Celebrex).
- Timeline: Typically stopped 7 to 10 days in advance. Acetaminophen (Tylenol) is often a safe alternative for pain relief during this time, but always confirm with your doctor.
Diabetes Medications
- Why they are stopped: Fasting before surgery necessitates careful management of blood sugar levels. Continuing medication as usual could lead to hypoglycemia (low blood sugar).
- Examples include: Metformin, GLP-1 agonists (Ozempic, Mounjaro), and insulin.
- Timeline: Your doctor will create a customized plan. Some medications are stopped a day or two before, while insulin doses may be adjusted.
Herbal Supplements and Vitamins
It is a common misconception that because supplements are natural, they are harmless. This is not the case. Many can interfere with blood clotting, anesthesia, or interact with other medications.
- Blood-clotting supplements: This includes fish oil, vitamin E, ginkgo biloba, and garlic supplements.
- Anesthesia interactions: St. John's Wort, valerian root, and kava can cause adverse reactions with anesthetic agents.
- Other supplements: Any multivitamin or herbal supplement should be disclosed to your surgical team. A general guideline is to stop all supplements two weeks before your operation.
Lifestyle Choices Before Surgery
Certain habits can significantly impact your body's ability to heal and respond to treatment.
Smoking and Vaping
- Why they are stopped: Smoking or vaping can damage the lungs, impair circulation, and slow down the healing process. It increases the risk of lung-related complications during and after anesthesia.
- Recommendation: Quitting several weeks or even months before surgery is best, but even stopping a few days prior is beneficial. Most surgeons require you to stop well in advance.
Alcohol Consumption
- Why it is stopped: Alcohol can affect liver function, blood clotting, and alter the effects of anesthesia and pain medication. Alcohol withdrawal symptoms can also complicate recovery.
- Recommendation: Avoid alcohol for at least 48 hours before surgery. Inform your doctor if you are a heavy drinker, as this requires careful medical management.
Recreational Drugs
- Why they are stopped: All illicit substances can have dangerous interactions with anesthesia. This includes marijuana, cocaine, and others.
- Recommendation: Be completely honest with your anesthesiologist about any drug use so they can plan accordingly and ensure your safety.
Fasting: A Non-Negotiable Requirement
Fasting before surgery is mandatory for your safety. Anesthesia relaxes the body's muscles, including those controlling your airway and stomach. If there is food or liquid in your stomach, it can be regurgitated and inhaled into your lungs (a condition called aspiration), which can be fatal.
- Solid food: No solid food typically for 8 hours prior.
- Clear liquids: Limited clear liquids (water, black coffee, apple juice) may be allowed up to 2 hours before, but you must follow your surgeon's specific rules.
- Crucial Reminder: Do not chew gum or eat hard candy after your fasting period begins, as this can stimulate stomach acid production.
Personal Items to Remove
For safety reasons, you will be required to remove several personal items before entering the operating room.
- Jewelry and Piercings: All items, including wedding rings and body piercings, must be removed to prevent surgical burns from electrocautery equipment.
- Makeup and Nail Polish: These items must be removed as they can interfere with monitoring devices, such as pulse oximeters, and hide a patient's natural skin tone, which can be an indicator of health status.
- Lotion and Powders: Avoid applying these the day of surgery, as they can interfere with skin prep and adherence of monitoring pads.
What to Stop Before Surgery: A Quick Comparison
| Item Category | Why You Must Stop | General Timeline | Specific Examples |
|---|---|---|---|
| Blood Thinners | Increased bleeding risk | Several days to a week before | Warfarin, Plavix, Aspirin |
| NSAIDs | Increased bleeding risk | 7-10 days before | Ibuprofen, Aleve |
| Herbal Supplements | Bleeding risk, anesthesia issues | 2 weeks before | Fish oil, Ginkgo Biloba, St. John's Wort |
| Smoking/Vaping | Poor circulation, lung health | As soon as possible | Cigarettes, vapes |
| Alcohol | Liver function, anesthesia | 48+ hours before | All alcoholic beverages |
| Fasting | Prevents aspiration | Specific hours before | All food and most liquids |
Conclusion: The Final Review
The most important takeaway is that your surgical team's instructions are paramount. They will provide you with a specific, tailored checklist detailing what to stop before surgery. Follow it meticulously. If you are unsure about anything, from a new supplement to a medication you forgot to mention, contact your surgeon's office immediately. Communication and preparation are your best tools for a smooth procedure and successful recovery.
For more information on preparing for a medical procedure, you can consult reputable sources such as MedlinePlus's patient instructions on what to do before surgery.
