What's allowed and forbidden before surgery? Fasting, smoking, alcohol, medications

In this video we'll sort it out for you: food, drink, smoking, alcohol, and medications — what's allowed and what could cause your surgery to be canceled at the last minute.

Some of the answers might surprise you.

And if you haven't yet seen my video on general anesthesia — I recommend watching that one too; I'll leave the link in the description below.

I'm Dr. Elisheva, I'm an anesthesiologist. Here you'll get clear, direct medical information — no scare tactics and no drama — so you can make informed decisions about your health.

Let's go.

## What can you eat and drink before surgery?

So you've probably already heard that you need to come fasting to surgery.

But maybe you didn't know why — when we're awake, we have mechanisms that prevent food in the stomach from entering our lungs. Under anesthesia those mechanisms are significantly weakened — meaning if there's content in the stomach, there's a risk it'll be aspirated into the lungs and cause respiratory damage that can be severe. That's why we're so adamant about fasting. There — now you know. No more secrets between us.

As I've explained in previous videos — fasting is 6 hours from food and 2 hours from clear liquids. But what counts as clear liquids?

You'll be surprised to hear that this includes a lot of things you might have thought were forbidden — water, tea with sugar, fully clear fruit juice (no pulp and no milk), sparkling water, and even black coffee like an Americano.

Not the thick mud (Turkish coffee).

And no milk (we're not performing a miracle here).

Milk, smoothies, juice with fruit pulp, soup — these are NOT clear liquids. They count as food in every way, meaning you need 6 hours of fasting.

For food — the meals allowed up to 6 hours before are light food, not fatty and not deep-fried. If you had an especially fatty meal, the recommendation is 8 hours fasting.

And another important point — there's no reason to extend the fasting hours beyond what's required, especially for drinking. It's even recommended to drink up until 2 hours before surgery to prevent dehydration, and this has been shown to speed recovery for certain surgeries.

And about gum — you're allowed to chew it up until the anesthesia, as long as you don't swallow it.

Why would you swallow it anyway?

## What about smoking and alcohol before anesthesia?

Smoking raises the risk of respiratory complications around anesthesia, and ideally it's recommended to stop at least 3 weeks before. But the good news is that stopping smoking even for a day or two before already gives some benefit, because it improves oxygen carrying in the body. And on the day of surgery, obviously, no smoking at all.

About alcohol — better to avoid it in the 24 hours before. If you're a regular daily drinker, it's very important to update your anesthesiologist, because it can affect how our anesthesia medications work.

## Can you continue your regular medications?

Almost all medications should be continued as usual up until surgery, so don't stop any medication on your own. Two groups of medications that we often ask people to stop are: 1) blood thinners (like warfarin/Coumadin, for example), and 2) diabetes medications (like glucophage/metformin). So if you take medications from these groups, it's very important to consult with your doctor to check if you need to stop them before, and when.

## What if you're sick before surgery?

It's very important to inform the team. A mild cold is fine, but if you're really feeling sick with a fever, a serious cough — then we'll probably need to postpone the surgery. We want you to arrive in the best possible medical condition so the anesthesia goes as safely as possible.

I hope this video helped you. If it did, subscribe to my channel. If there are more things you want to know about what's allowed or forbidden before anesthesia, write below and I'll answer.

See you in the next video.