Procedure Guidelines

Here are some guidelines to help you prepare for your surgical procedure.
If you have any medical conditions, or have had any medical conditions in the past, your surgeon may ask you to visit your primary care doctor for a check-up to ensure your safety. This is usually just a precaution, but as responsible health care providers our goal is to make sure that you are as safe as possible. On the day of your procedure, the anesthesia provider will review your health history, medications, allergies and past experiences with anesthesia, and recommend the best plan for your care.


Do not eat any solid food or drink thick liquids or milk for six hours prior to your procedure.

  • If you are overweight or have problems with food moving through your system in a normal manner, or you are diabetic, please do not eat anything for a minimum of eight hours prior to your procedure.
  • You can have clear liquids up to two hours before surgery. Clear liquids include drinks with no added sugar or milk, i.e., black coffee, juices without pulp, and water.
  • Please do not have any clear liquids, even water, within two hours of your procedure.

Your physician may have special instructions regarding abstinence from food and drink depending on your underlying medical condition and the type of procedure or surgery you are scheduled for. She or he will discuss these with you prior to the day of your procedure.


You will wake up in a recovery area where your post-operative condition will be monitored until you are ready to be released if you had an ambulatory or “day” surgery. If your post-operative recovery requires hospitalization, you will be transferred to either a hospital room or an intensive care setting depending on the nature of your procedure and your medical condition.

If you are to be discharged home after an ambulatory surgery or procedure, make sure you have a responsible adult with a valid driver’s license to accompany you. Typically, you should not drive, operate heavy machinery, consume alcohol, or engage in strenuous physical activity for 24 hours following your discharge to home. You may eat and drink shortly afterward, but please forgo heavy meals for at least several hours. The nature of the procedure or surgery and your specific medical profile may dictate a different protocol when it comes to eating, drinking and activity after discharge. Your surgeon will discuss these matters with you prior to your discharge.

What are the Different Types of Anesthesia?

There are several modalities of anesthesia. Which type(s) you receive depend on a variety of factors that include, but are not limited to, the type of procedure or surgery you are having, medical conditions you may have and your age. Whichever form(s) of anesthesia you receive, the objective is to relieve discomfort and pain during surgery and, in some cases, provide sedation and “amnesia” that prevents you from recalling the events immediately surrounding your surgery.

Here are some basic definitions of the various types of anesthesia you may receive, depending on your procedure.

Local Anesthesia:

A limited area of the body is infiltrated with anesthetic in order to numb the region for a superficial excision. An example is the removal of a mole or a skin biopsy.

IV Sedation:

Anesthetic medication is injected through an IV. You may be conscious or unconscious depending on the quantity of anesthetic given.

Regional Anesthesia:

A specific part, or parts, of the body are numbed by injecting anesthetic in order to surround a nerve, or cluster of nerves. That body part(s) becomes insensitive to painful stimuli. The patient may receive additional sedative medication through an IV to help alleviate anxiety surrounding the surgery.

Examples of regional anesthesia include an awake C-section performed with spinal or epidural anesthesia, and hand surgery after an injection in the armpit area.


This is an acronym for monitored anesthesia care. Patients are typically given intravenous anesthesia while their vital signs are monitored by the anesthesiologist and/or CRNA. The patient typically breathes on his/her own and the airway reflexes are intact. If the patient loses the ability to protect her/his airway and requires assistance with breathing, it is considered general anesthesia.

General Anesthesia:

Refers to any situation where the patient is anesthetized and doesn’t respond to even a painful stimulus. Because general anesthesia usually creates a plane of anesthesia deep enough to impair the patient from breathing on her/his own, a breathing tube and external ventilation is often required.

A variety of gases may be administered through the endo-tracheal tube along with oxygen. Several medications are also delivered through the IV including muscle relaxants to facilitate the surgical procedure as well as potent narcotic pain relieving medication such as fentanyl. Surgical procedures done under general anesthesia include appendectomy, gallbladder removal, hysterectomy, and more.

Anesthesia FAQs for Patients

Q: What are the different types of anesthesia?

A: There are several modalities of anesthesia available that provide insensitivity to pain. Whichever form you receive, the objective is to relieve discomfort and pain during surgery and often provide sedation and “amnesia” that prevents recall of the events immediately surrounding your surgery.

Learn about your anesthesia options

Q: Are there any risks associated with anesthesia?

A: The evolution of medical technology and innovations in pharmaceutical science have improved outcomes and patient safety in anesthesia dramatically over the last several decades. While the overall risk of anesthesia-related complications in the United States is exceedingly low, any surgical procedure and associated anesthetic modalities carry some inherent risk.

It is the responsibility of your primary care physician, any specialists, the anesthesiologist and/or CRNA and the surgeon to assess the risks associated with your procedure and anesthesia. The goal of this care team is to optimize your condition prior to surgery and anesthesia, and to provide the needed attention before, during and after the procedure to avoid and minimize any possible risks.

Q: My procedure is coming up and I feel like I am getting a cold. Should I inform my doctor?

A: Yes. You should always inform your surgeon of any changes in your health that you suspect may impact your care during or after your procedure or surgery. A cold is an upper respiratory infection and may lead to respiratory/breathing problems secondary to a variety of factors. It will be up to your surgeon to decide whether to delay/postpone your procedure or surgery.

Q: Am I allowed to eat or drink the day of the procedure?

A: A safe protocol involves eating or drinking nothing past midnight the day before your procedure. For healthy patients the absolute cut-off for solid food is six hours prior to surgery. The same applies to thick liquids such as pudding or yogurt.

Clear liquids including coffee without sugar or milk products and juice without pulp are typically permissible up to two hours prior to surgery. There are exceptions to these guidelines based on a variety of factors such as age and underlying medical conditions. Consult your physician about eating and drinking prior to your procedure or surgery.

Q: What if I need water to take my usual prescription medicine?

A: Prescription medications can be taken with a small sip of water the morning of surgery. However, there are some prescription medications that your physician will want you to abstain from on the day of surgery or several days prior. Your doctor may also advise you to avoid certain over-the-counter medications for a defined period of time before surgery. Be sure to discuss the guidelines for each of your medications with your physician(s).

Q: Will I be able to drive home after my procedure?

A: Driving, operating heavy machinery and strenuous exercise should be avoided after any procedure requiring anesthesia. The length of time to abstain from such activities depends on several factors such as the type of surgery or procedure and the modality of anesthesia. Your physician and nursing team should discuss these items with you prior to and after surgery. It is imperative that a responsible adult with a valid driver’s license or with the means to assist you through some safe form of transportation accompany you to and from the procedure.

Q: My throat is scratchy after my procedure. Is that normal?

A: Occasionally, anesthesia might cause a sore throat. Normally, these symptoms will disappear within 24 hours, but gargling with warm water or a chloraseptic spray may help.

The breathing tube typically used in general endo-tracheal anesthesia may cause some throat discomfort for a day or two after surgery. Treatment with pain relievers and throat lozenges will likely alleviate the symptoms. If the discomfort does not resolve and/or you have hoarseness, you should contact your physician immediately.

Q: I have a bruise on my arm where the IV was. Should I be worried?

A. Bruising after intra-venous placement and removal is not uncommon. Severity of bruising depends on several factors such as technique, size of the catheter, medications (i.e. blood thinners) or clotting-related issues. The bruising will typically resolve. Treatment includes elevating the area if possible and applying a cold pack for 15 minutes every four hours. Applying a warm heating pad after 48 hours can help relieve pain and promote the healing process. Over-the-counter pain medication can provide additional pain relief. Please contact your physician immediately if the site becomes red, hot, sensitive, inflamed or swollen, or if you get a fever. If your physician’s office is closed, refer to the local emergency department.

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