It’s important to understand your anesthesia options as you prepare for an upcoming procedure or surgery. Talk with your care team about the following questions. Each answer may vary based on your unique situation.

When you receive care at MedStar, you can expect to work with a compassionate team of providers that may include:

  • Anesthesiologist: A doctor specially trained to keep you safe and comfortable before, during, and after medical and surgical procedures using anesthetics
  • Certified Anesthesiology Assistants (CAA): A highly skilled provider trained to provide anesthesia under the direction supervision of an anesthesiologist
  • Certified Registered Nurse Anesthetist: An advanced practice clinician who is certified to administer anesthesia and care for patients recovering from anesthesia under the direction of an anesthesiologist
  • Registered Nurse: A health professional trained to care for ill or injured patients
  • Surgeon: A doctor specially trained to operate on patients

To keep you safe, there are special rules about when to stop eating and drinking. Your care team will advise you on when to stop eating or drinking before a procedure to ensure a safe procedure and prevent nausea.

The following are general guidelines for adults over the age of 19:

Solid foods You may eat solid foods up to eight hours before your scheduled arrival time for your procedure. Once you are eight hours away from your arrival time, please refrain from eating food or consuming alcoholic beverages, milk, or dairy products.

Non-Clear Liquids You  may drink non-clear liquids up to six hours before your scheduled arrival time. Non-clear liquids include:

  • Non-human milk
  • Orange juice
  • Apple cider

Clear Liquids Staying hydrated is important, so you can—and should—drink clear liquids up to two hours before your scheduled arrival time. Clear, “see-through” liquids include:

  • Water
  • Clear fruit juice such as apple juice
  • Plain tea or black coffee (without milk or creamer)
  • Electrolyte-replenishing drinks such as Gatorade or Powerade

DO NOT drink milk, alcohol, or dairy products.

Here is a sample schedule of when to stop eating and drinking, based on your scheduled arrival time.

Stop Solid Foods at

Stop Non-clear Liquids at

Drink Clear Liquids Until

Arrival Time

10 p.m.

12 a.m.

4 a.m.

6 a.m.

2 a.m.

4 a.m.

8 a.m.

10 a.m.

6 a.m.

8 a.m.

12 p.m.

2 p.m.



Pediatric Patients

Pediatric patients should follow the above guidelines, as well as the following recommendations:

Formula: Infant formula may be consumed up to six hours before their scheduled arrival time.

Breast milk: Breast milk may be consumed up to four hours prior to arrival.

Exceptions

Please note that some surgeries may require you to fast. Your care team may advise you to modify the above guidelines if you need emergency surgery or have any of the following conditions:

  • Body Mass Index (BMI) greater than 40
  • Chronic narcotic use
  • Diabetes Mellitus with neuropathy
  • End-stage renal disease on haemodialysis
  • Hiatal hernia
  • History of difficult airway
  • Ileus or bowel obstruction
  • Pregnancy (past 12 weeks)
  • Severe gastroesophageal reflux disease (GERD)

Be sure to follow the instructions from your surgeon or anesthesia team. Failure to follow these guidelines may result in delay or cancellation of the procedure.

Typically, your provider will advise you to continue taking your regular medications. However, you may be instructed to change your medication schedule or STOP taking certain medications, depending on your procedure and medical history.

 

Talk to your anesthesia provider about the following medications:

 

Blood Pressure Medications If you are on blood pressure medications, talk to your doctor about whether or not you should take a dose the night before surgery.

 

When you receive anesthesia, your anesthesiologist or CRNA will monitor your blood pressure before, during, and after surgery, and will deliver more medication through your IV, if you need it.

 

Diabetes Medications If you take pills for diabetes, your doctor will likely recommend that you take the evening dose the night before surgery but refrain from taking the morning dose on the day of your procedure. If you are on insulin, talk to your doctor about lowering your dose on the morning of the surgery.

 

When you arrive for surgery, let your care team know that you are diabetic. They will monitor your blood sugar to ensure it remains at a safe level.

 

Blood Thinning Medications (Anticoagulants, Aspirin) If you take medication to prevent blood from clotting, your care team will advise you to discontinue the medication a few days before surgery.

 

If you take aspirin, your doctor and anesthesia team will discuss with you whether you should stop or continue taking it before your surgery.

Prior to your procedure, your care team will determine the best type of anesthesia to manage your pain while preparing you for a safe recovery. Our anesthesiologists and CRNAs are experts in a variety of pain relieving techniques, so you won’t feel any pain during your surgery.

If you are receiving general anesthesia, you are most likely going to be unconscious for your entire procedure. You will be unaware of what’s happening, and you won’t remember anything afterward.

 

Waking up during surgery is highly unlikely, occurring in only one of every 1,000 medical procedures involving general anesthesia. Your anesthesiologist and CRNA will help reduce your risk of awareness by thoroughly reviewing your medical history, including:

  • Previous problems with anesthesia
  • Medications you are taking
  • Concerns you have
  • History of drug or alcohol use

 

We also can monitor how "awake" or "asleep" you are with an innovative technology called Bispectral Index or BIS monitor. The BIS monitor enables our anesthesiologists to provide just the right amount of anesthesia so that you can awake faster after surgery with less chance of nausea and grogginess.

BIS monitoring is non-invasive, which means there are no catheters or needles required. A BIS sensora long adhesive strip with a tab at one endis placed on your forehead. Then the sensor is connected through a cable to a monitor. Together, the sensor and monitor measure your brain activity and compute a number that correlates with your level of consciousness.

Prior to your surgery, your care team will talk with you about a postoperative plan to manage your pain. While you will have discomfort following your procedure, our anesthesia providers are experts in helping patients recover quickly and safely with minimal pain.

 

Your anesthesia team will use a variety of techniques before surgery to proactively minimize your pain before your procedure. Following your surgery, you can expect the same care and attention to relieving your pain as your anesthesia team works to minimize opioid use when possible.


Your anesthesiologist may use one or more of the following pain management techniques after surgery:

 

  • Epidural Anesthesia – Your anesthesia provider will place a thin tube, called a catheter, in your back. The tube remains there throughout the procedure so your care team can deliver medicine through the catheter as you need it. Following surgery, you will continue to receive pain relief medication through the catheter.
  • Nerve blocks – Medication is injected around large nerve groups to reduce pain in a specific area of the body
  • Opioid medications – Pills taken orally to manage pain