Getting yourself healthy before surgery

Tell your surgeon about:

• Any reactions or allergies you have had to medicines, foods, skin tapes, adhesive, iodine or other skin cleansing solutions, or latex
• Your use of alcohol (especially if you're drinking more than 1 or 2 drinks a day) or illicit drugs
• Problems you had before with surgery or anesthesia
• Blood clots or bleeding problems you have had
• Recent dental problems, such as infections or dental surgery
• Your use of cigarettes or tobacco
• Medicines that you take

If you get a cold, the flu, a fever, herpes breakout or another illness in the few days before surgery, call your surgeon right away. Your surgery may need to be rescheduled.

Before your surgery, you may need to have a medical assessment. Ask your surgeon if this is needed.

• This may be done by your surgeon or your primary care provider (PCP).
• You may need to visit a specialist who takes care of problems such as diabetes, lung disease, or heart disease. Your PCP can tell you if this is necessary.
• Your surgeon or PCP will schedule an appointment, usually a few weeks before surgery. That way, your providers can take care of any medical problems you might have well before your surgery.

Most hospitals will also have you visit with an anesthesia provider at the hospital or have a phone call from the anesthesia nurse before surgery.

• You will be asked many questions about your medical history.
• You may also have a chest x-ray, lab tests, or an electrocardiogram (ECG) ordered by the anesthesia provider, your surgeon, or your PCP before surgery.

Bring a list of medicines you are taking with you every time you see any provider. This includes medicines you bought without a prescription and medicines you do not take every day. Include information on the dose and how often you take your medicines.

Also tell your providers about any vitamins, supplements, minerals, or natural medicines you are taking.

Two weeks before surgery, you may need to stop taking medicines that put you at risk of bleeding during surgery. Medicines include:

• Nonsteroidal anti-inflammatory drugs (NSAIDs) such as aspirin, ibuprofen (Advil, Motrin), naproxen (Naprosyn, Aleve)
• Blood thinners such as warfarin (Coumadin), dabigatran (Pradaxa), rivaroxaban (Xarelto), apixaban (Eliquis), clopidogrel (Plavix)
• Vitamin E

Ask your surgeon which medicines you should still take on the day of your surgery.

If you have diabetes, heart disease, or other medical problems, your surgeon or PCP may have you see the providers who treat you for these problems. Your risk for problems after surgery will be lower if your diabetes and other medical conditions are under control before surgery.

You may not be able to have dental work for 3 months after certain surgeries (joint replacement or heart valve surgery). So be sure to schedule your dental work before your surgery. Ask your surgeon about when to have dental work before the surgery.

If you smoke, you need to stop. Ask your provider for help. Smoking will slow your healing after surgery.

Tell all your providers that you are having surgery. They may suggest a change in your medicines before your operation.

Preoperative care - getting healthy

Auerbach AD. Preoperative evaluation. In: Goldman L, Cooney KA, eds. Goldman-Cecil Medicine. 27th ed. Philadelphia, PA: Elsevier; 2024:chap 399.

Centers for Disease Control and Prevention website. Tips for being a safe patient. www.cdc.gov/patient-safety/about/index.html. Updated April 12, 2024. Accessed October 23, 2024.

Zaydfudim VM, Hu Y, Adams RB. Principles of preoperative and operative surgery. In: Townsend CM Jr, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery. 21st ed. St Louis, MO: Elsevier; 2022:chap 10.

Updated by: Linda J. Vorvick, MD, Clinical Professor, Department of Family Medicine, UW Medicine, School of Medicine, University of Washington, Seattle, WA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.