Anesthesia Instructions & Guidelines


You will always be given local anesthesia for your surgery, but you may choose any of those listed below as a supplement.  Each choice requires different preparation on your part, and for your safety it is important that you read and follow the instructions carefully.  If you are unclear about anything, please ask your doctor.  For all surgery, please wear comfortable, loose-fitting clothing, and remove all jewelry & contacts lens prior to arriving.  Tops/shirts should have sleeves that are easily drawn up above the elbow.  Females should remove nail polish before surgery, and apply as little makeup as possible.



LOCAL ANESTHESIA will produce a numb feeling in the area being operated on and a feeling of pressure during surgery.  You will be awake and recall the surgery, but there should be no significant discomfort.

  1. Have a light meal a few hours prior to surgery.
  2. For more extensive procedures you may wish to have someone drive you home.
  3. If you prefer to listen to your own music during procedures with local anesthesia, feel free to bring a Ipod etc…
  4. Plan to rest for a few hours after surgery.
  5. ORAL PREMEDICATION: may be a supplement to local anesthesia and is medication taken by mouth to produce relaxation before and during your operation.
  6. Take the medication at the time directed before your surgery.
  7. Have a light meal a few hours prior to surgery unless you are also having intravenous or general anesthesia.
  8. It is not safe to drive after taking sedative drugs, and you MUST have someone drive you to and from surgery.
  9. Plan to rest for the remainder of the day. Do not operate power tools, machinery, etc., for 24 hours after surgery.


NITROUS OXIDE is also known as “laughing gas.”  You will be relaxed and somewhat less aware of your surroundings, but will recall most of the surgical event.  Nitrous oxide is generally used in conjunction with local anesthesia, but may also be used to supplement the anesthetic choices below.

  1. You may have a light meal four (4) hours prior to surgery.
  2. It is best to have someone drive you home.
  3. Plan to rest for the remainder of the day.


INTRAVENOUS ANESTHESIA: Medications are given through a vein in your arm or hand, which will cause total relaxation and, although you will not actually be unconscious, there will be very little recall (if any) of the events surrounding surgery.

  1. Do not eat or drink anything (including water) for eight (8) hours prior to surgery. However, it is important that you take any regular medications (high blood pressure, antibiotics, etc.) or any pre-medication prescription that we have provided, using only a small sip of water.
  2. If you are diabetic, please hold your morning insulin or oral hypoglycemic. Please bring your insulin and glucometer with you the day of surgery
  3. For morning appointments, skip breakfast.
  4. For afternoon appointments, eat a light breakfast eight (8) hours before your appointment and skip lunch.
  5. Take any regular medications with only enough water to get the pill down.
  6. You MUST have someone drive you to your appointment, and stay during your procedure until you are discharged. Please do NOT plan to drop you off for your procedure, and return to pick you up when you are ready to be discharged.
  7. Plan to rest for the remainder of the day. Do not operate power tools, machinery, etc., for 24 hours after surgery.  On some occasions, especially in the elderly, it takes longer than expected, weeks, to fully recover from the anesthetic effects. 


BLOOD THINNERS:  For patients taking blood thinners there is of course a more significant chance of post operative bleeding.  But usually the risks of completely normalizing coagulation levels outweighs the benefits.  It is not usually necessary to stop taking Aspirin, NSAIDS, or  Clopidogrel (Plavix), unless they are taken in combination with other blood thinners.  In most cases for patients taking Warfarin (Coumadin) a recent INR within 2 weeks of 2.5 or less and in the therapeutic level is usually acceptable.  For patients taking Xarelto (Rivarxaban), Dabigatran (Pradaxa) or Apixaban (Eliquis), it is usually recommend to stop taking one day before surgery and the day of surgery.  It is your responsibility to check with the prescribing doctor of your anticoagulant is to confirm our recommendation.