Pre-operative surgery instructions
You are scheduled for surgery at Pennsylvania Hospital. Get directions to Pennsylvania Hospital and view parking locations.
There are several things you need to know and do before your procedure for the best surgical experience. Read the instructions below before your surgery to help you prepare. If you do not follow these directions, your procedure may need to be canceled or rescheduled.
The week before surgery
What medications to stop before surgery
- Seven (7) days before surgery, STOP taking:
- Over-the counter medications
- Herbal supplements
- Vitamins, including fish oil
- Aspirin and aspirin-containing medications: Pepto-bismol, Excedrin, anacin, bufferin, fiorinal, ascription, Alka-seltzer, lortab ASA
- NSAIDS (non-steroidal anti-inflammatory drugs): Ibuprofen (advil, motrin), Celebrex, Feldene (piroxicam), Naproxen (Aleve, Anaprox, Naprosyn), Toradol (ketorolac), Relafen (Nabumetone), Diclofenac (arthrotec, cataflam, voltaren), Lodine (etodolac)
- Accutane
- Three (3) days before surgery, STOP taking:
- Suboxone or Buprenorphine-containing products
- Cialis
You will need your healthcare provider’s permission before stopping any of the following medications, especially if you have a stent. You may be instructed to bridge with Lovenox while your regular medication is stopped.
If your surgery is cancelled for any reason, call your healthcare provider, because you may need to restart the blood-thinning medications.
The following is a list of blood-thinners and recommended timelines to discontinue prior to surgery
|
Drug name |
When to stop taking before surgery |
|
Apixiban (Eliquis) |
3 days |
|
Betrixaban (Bevyxxa) |
3 days |
|
Cilostazol (Pletal) |
2 days |
|
Clopidogrel (Plavix) |
7 days |
|
Dabigatran (Pradaxa) |
5 days |
|
Dipyridamole (Persantine, Aggrenox) |
1 days |
|
Edoxaban (Savaysa) |
3 days |
|
Enoxaparin (Lovenox) |
24 hours |
|
Prasugrel (Effient) |
7 days |
|
Rivaroxaban (Xarelto) |
3 days |
|
Ticagrelor (Brilinta, Brilique, Possia) |
10 days |
|
Ticlopidine (Ticlid) Warfarin (Coumadin) |
5 days or Normal INR 3 7. |
The day/night before surgery
Plan “morning of surgery” directions with instructions about managing your medications, food and drink, and what to (not) wear or bring to the hospital. Patients scheduled for outpatient surgery should be prepared to spend a full day at the hospital.
- The clinical team will call you one business day before surgery to give you your scheduled arrival time and location. (Patients having surgery on Monday will receive a phone call on Friday.)
- If you have NOT received a phone call about your scheduled arrival time the business day before your surgery, please call your surgeon's office before 4 p.m.
The day before your surgery:
- Do NOT eat solid food or smoke after midnight.
- Do NOT drink alcoholic beverages 24 hours prior to surgery.
You may have the following clear liquids up until 2 hours prior to your arrival time:
- Clear fruit juice
- Gatorade
- Propel water
- Kool-Aid
- Lemonade
- Follow medication instructions given to you by your provider.
- Take Extra Strength Tylenol 1000 mg (2 tabs) on the way to the hospital.
- Take Ibuprofen 600 mg (Motrin, Advil; 3 tabs) on the way to the hospital.
- Follow bowel prep instruction, if needed.
- Follow full body cleansing wipe instructions, if ordered by your provider.
What medicine to CONTINUE taking
Diabetic medications: The night before surgery, take your oral medications or insulin after your last meal of the day, as you normally do.
- Outpatients: Per mandatory hospital policy, patients receiving outpatient surgery must arrange for a responsible adult to accompany you home after your procedure. Failure to have a responsible adult to accompany you home can result in the cancellation or rescheduling of your procedure. Note: If you are planning on taking a bus, cab, rideshare or paratransit as your means of transportation, the driver is NOT considered your responsible adult.
- Inpatients (staying overnight): If you are staying overnight in the hospital, please arrange your transportation back home in advance. The estimated discharge time is 10 a.m.
Morning of surgery
Do NOT eat solid food or smoke.
Please follow the “morning of surgery” medication instructions from your surgeon.
If applicable, continue taking these medications with only a sip of water:
- Beta-blockers (e.g. Atenolol, Metoprolol, Levatol, Bystolic, Coreg, Propranolol)
- Seizure medications
If applicable, follow directions for diabetic medications:
- DO NOT take oral diabetic medications
- If taking insulin, DO NOT take your normal dose. Please contact your prescribing physician for advice on altered dosage.
If applicable, follow directions to “prep” your skin for surgery.
Dress in clean, loose, comfortable clothing.
Remove contact lenses and wear your glasses, as you may need to read and sign documents.
Do NOT wear:
- Nail polish or artificial nails
- Makeup or other cosmetics
- Jewelry (including piercings, wedding bands)
- Contact lenses