Pre-operative surgery instructions
You are scheduled for surgery at Pennsylvania Hospital. Get directions to Pennsylvania Hospital.
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
Do not smoke. Continue your normal diet and activity routine unless instructed otherwise by your surgery team.
Your surgeon needs you to attend required appointments for testing, imaging and clearance before your surgery.
- Pre-admission testing
- Pre-operative labs
- Pre-operative imaging, as ordered by your surgery team. (A chest X-ray is required if you are over 60 years old or have a history of smoking.)
- If requested by your surgeon: A primary care and/or cardiology appointment for medical clearance.
Fill your prescriptions (to take the day before surgery):
- Erythromycin - 1 g (for 3 doses)
- Neomycin - 1 g (for 3 doses)
Purchase “bowel prep” supplies:
- 510 g or 525 g of Miralax (or generic substitute)
- 64 oz of liquid (non-red) Gatorade, Powerade or Propel Water
- 20 oz of (non-red) Gatorade or Powerade, for the day of surgery
Discuss with your doctor(s) which medications to take/hold before your surgery:
- Speak with your surgeon about holding NSAIDs (e.g. ibuprofen, naproxen) for 7 days before surgery.
- Speak with your surgeon about holding Plavix for 7 days before surgery.
- Speak with your cardiologist about holding Coumadin in other anticoagulation medications for 5 days before surgery.
- Speak with your doctor about holding Methotrexate/Remicade/Humira.
Continue to take any other normal medications (including aspirin) not listed.
Stay on top of pre-surgery logistics by signing up for Penn Medicine’s patient portal MyChart by myPennMedicine to contact your doctor’s office with questions about your surgery and care plan.
The day/night before surgery
Note: Call the OR for surgery time if you are not contacted by 5 p.m. the day before.
- Do not drink alcohol for at least 24 hours before surgery. Alcohol can react with some of the medicine you will be given at the hospital.
- Drink only clear liquid the day before surgery. You may continue to drink clear liquids up until 2 hours before you are scheduled to arrive at the hospital for your surgery.
- 3 p.m.: Take two erythromycin and two neomycin tablets with 8 oz of water.
- 4 p.m.: Mix the Miralax in 64 oz of your choice of liquid Gatorade, Powerade, or Propel Water. Drink one 8 oz glass of the mixture every 20 minutes until you drink all of the mixture. If nauseated, slow down your drinking by increasing the intervals between glasses.
- 5 p.m.: Take two erythromycin and two neomycin tablets with 8 oz of water.
- 7 p.m.: Take two erythromycin and two neomycin tablets with 8 oz of water.
Only drink clear liquids after 6 p.m. You may continue to drink clear liquids up until two hours before your surgery.
To prevent infection, you must shower before going to bed the night before your scheduled surgery. Please shower around 9 p.m.
You will be provided with one bottle of HIBICLENS body wash.
- Have a fresh, clean towel ready near shower.
- With mild soap, shower and wash thoroughly as you normally would. Rinse head and entire body.
- Shut off the water.
- Pour HIBICLENS soap onto clean washcloth.
- Wash thoroughly all areas listed below for two minutes. Caution: Do NOT apply HIBICLENS soap to face, and do NOT allow it to get in your eyes or ears.
- Turn water back on and rinse off fully.
- Pat yourself dry with a clean towel.
- Change into clean pajamas and go to sleep on clean bedding.
Do not bathe again, or apply cosmetics, deodorant, or lotions before your surgery.
Morning of surgery
On the morning of your operation, you may sip clear liquids up until two hours before your surgery.
- Take your medications as instructed by the surgery team. If you have diabetes, hold your oral diabetes medication and take one half of your insulin dose.
- Drink a 20 oz Gatorade or Powerade. This drink must be finished 2 hours before your surgery or by the time you are scheduled to arrive at the hospital.
- If you use them, bring your CPAP machine, cane and walker to hospital with you.
- After arriving at the hospital at the assigned time, you will go to the pre-operative holding area.
Get in top shape
- Exercise will help get your body fit for surgery: If you exercise regularly, continue to do so. If you don’t, add some activity to your day. Even a 15 minute walk daily can help get you fit.
- For those who smoke: Talk to your doctor if you need help to stop smoking. When you stop smoking you reduce the risk of lung problems.