How to Prepare for Surgery: A Complete Pre-Op Guide

Updated March 28, 2026 • 10 min read • By National Healthcare Connect

Surgery is stressful. Knowing exactly what to expect and how to prepare removes much of that anxiety — and actually improves outcomes. Studies consistently show that patients who are better prepared have fewer complications, recover faster, and report higher satisfaction with their care. Here is what you need to know.

Weeks Before Surgery: The Foundation

Complete Your Pre-Operative Appointments

Most surgical patients need a pre-operative (pre-op) assessment — typically one to two weeks before the procedure. This may be with your surgeon, your primary care doctor, or an anesthesiologist. The purpose is to evaluate your overall health, identify any risk factors, and clear you for surgery.

Bring to this appointment:

• A complete list of all medications, vitamins, and supplements you take (with doses)
• Your medical history, including all prior surgeries and any anesthesia reactions
• A list of allergies — medications, latex, food, contrast dye
• Insurance cards and ID
• Any prior relevant test results (ECG, imaging, bloodwork)

Medication Review — What to Stop and When

This is one of the most critical parts of surgical preparation. Certain medications significantly increase bleeding risk, interact with anesthesia, or affect healing. Your surgical team will give you specific instructions, but common medications that typically need to be stopped before surgery include:

• Blood thinners (anticoagulants): Warfarin (Coumadin), Eliquis, Xarelto, Pradaxa — typically stopped 3–7 days before surgery. Never stop without your doctor's explicit instruction on timing.
• Antiplatelet drugs: Aspirin, clopidogrel (Plavix) — often stopped 5–10 days before surgery, but cardiac patients may continue on medical direction.
• NSAIDs: Ibuprofen (Advil, Motrin), naproxen (Aleve) — typically stopped 1–2 weeks before. Use acetaminophen (Tylenol) for pain in the pre-op period if allowed.
• Herbal supplements: Many herbs affect bleeding or interact with anesthesia — garlic, ginkgo, ginseng, St. John's Wort, fish oil, vitamin E. Stop most supplements 1–2 weeks before surgery unless told otherwise.
• Diabetes medications: Specific guidance from your care team is essential — especially for insulin and metformin, which often require dose adjustment or temporary discontinuation around the time of surgery.
• GLP-1 receptor agonists (Ozempic, Wegovy, Mounjaro): These slow stomach emptying and pose aspiration risk. Most anesthesiologists now recommend stopping weekly injections one week before surgery and daily doses on the day of surgery.

Do not stop any prescribed medication without explicit guidance from your surgeon or anesthesiologist. Some medications — cardiac, seizure, and blood pressure medications, for example — must continue right up to surgery day.

Quit Smoking (Even Temporarily)

Smoking significantly increases surgical risk — impaired wound healing, higher infection rate, increased clotting risk, and reduced respiratory reserve during anesthesia. Stopping even 2–4 weeks before surgery meaningfully reduces these risks. If you can quit 8 weeks out, outcomes improve substantially. Your surgical team can connect you with cessation resources if needed.

Avoid Alcohol

Alcohol affects anesthesia metabolism, increases bleeding risk, and impairs immune function and wound healing. Most surgeons recommend avoiding alcohol for at least 48 hours before surgery; many recommend 1–2 weeks, especially for major procedures.

The Night Before Surgery

Fasting Instructions (NPO: Nothing by Mouth)

Fasting before surgery is not arbitrary — it prevents aspiration, a dangerous complication where stomach contents enter the lungs under anesthesia. Current guidelines from the American Society of Anesthesiologists (ASA) are:

• Solid food: Nothing after midnight before your surgery, or as directed (typically 8 hours before)
• Milk, cream, alcohol: Stop 6 hours before
• Clear liquids (water, clear juice, black coffee, plain tea): Usually allowed up to 2 hours before for most patients. Confirm with your specific surgical team — some hospitals have stricter protocols
• Medications: Ask your team specifically which medications you should take the morning of surgery and whether to take them with a small sip of water

If you accidentally eat or drink beyond your fasting window, contact your surgical team immediately. Surgery may need to be rescheduled for safety.

Personal Preparation

• Shower with antiseptic soap if provided (chlorhexidine washes are commonly given pre-op for certain surgeries to reduce infection risk)
• Do not shave the surgical site yourself — this increases infection risk. The surgical team will prepare the area if needed
• Remove nail polish (at least from one finger) — pulse oximetry needs to read through your fingernail
• Skip makeup, lotions, and deodorant on surgery day
• Remove piercings and jewelry
• Wear comfortable, loose clothing you can put on easily after surgery

Prepare Your Home for Recovery

Recovery is easier if you set things up in advance. Before surgery day:

• Fill any post-operative prescriptions so they are ready when you return home
• Set up a recovery area on the main floor if stairs will be difficult
• Stock up on easy-to-prepare foods, especially soft foods if you are having any procedure affecting your mouth, throat, or GI tract
• Arrange transportation — you cannot drive yourself home after any procedure involving anesthesia or sedation, and you will need someone present for the first 24 hours
• Arrange childcare or pet care if needed
• Prepare a bag: ID and insurance cards, a list of medications, phone charger, change of comfortable clothes, glasses/contacts case if applicable

Day of Surgery: What to Expect

Check-In and Pre-Op Processing

Arrive at the time your surgical team specifies — usually 1–2 hours before the scheduled procedure. During check-in and pre-op preparation:

• You will change into a hospital gown and store your belongings
• A nurse will take your vital signs, review your medical history, confirm your medications, and start an IV
• The anesthesiologist will review your anesthesia plan and answer questions
• Your surgeon will mark the surgical site (for procedures where this applies) and confirm the plan
• You will be asked to sign informed consent documents if not completed earlier

You will have opportunities to ask questions at multiple points. Do not hesitate to ask — about the procedure, the anesthesia, recovery expectations, or anything unclear.

In the Operating Room

The operating room is bright, cool, and busy. The temperature is kept low to reduce infection risk. You will be positioned on a narrow table with staff all around you. Anesthesia induction (if general) is fast — most patients describe going from awake to asleep within seconds. The next thing you typically know, you are in recovery.

Post-Anesthesia Care Unit (PACU) / Recovery

After surgery, you will wake up in the recovery room (PACU) with nurses monitoring your vital signs, pain level, and alertness. Common experiences waking from anesthesia include confusion, nausea, shivering, dry mouth, and grogginess. All are normal and temporary.

Pain management begins in recovery. Communicate your pain level honestly — there is no benefit to minimizing it, and effective early pain control leads to better outcomes.

For outpatient (same-day) procedures, you will be discharged once you are alert, your vitals are stable, you can take liquids without nausea, and you have demonstrated safe mobility. Your companion will need to be present to receive discharge instructions and drive you home.

Questions to Ask Before Your Surgery

Being an informed patient leads to better outcomes. Bring these questions to your pre-op appointments:

• What are the risks and benefits of this specific procedure?
• What type of anesthesia will I receive and what are the risks?
• What is the expected recovery timeline and when can I return to work/driving/activity?
• What should I do if I experience complications after discharge?
• What medications should I take the morning of surgery?
• Are there alternatives to this procedure I should consider?
• What happens if I do not have this surgery?

Warning Signs to Watch for After Surgery

Contact your surgical team or go to the ER immediately if you experience any of the following after discharge:

• Fever above 101.5°F (38.6°C)
• Increasing redness, warmth, or swelling at the incision site
• Pus or unusual discharge from the wound
• Pain that is worsening rather than improving
• Difficulty breathing or chest pain
• Calf pain, swelling, or warmth (possible deep vein thrombosis)
• Inability to keep any liquids down
• No bowel movement for 3+ days after abdominal surgery

This article is for informational purposes only and does not constitute medical advice. Always follow the specific pre-operative instructions provided by your surgical team.