You may not eat or drink anything for eight hours before surgery with the exception of some (but not all) medications. Please understand that eating too close to your scheduled surgery may require rescheduling of your surgery.

Required tests may include blood work, heart testing (EKG, stress test, etc) or x-rays. If your procedure is scheduled at Saint Mary’s Regional Medical Center, you should be evaluated by the STAR Clinic prior to your procedure. All tests need to be done within 30 days of your procedure.

No. Pre operative testing is generally not required for patients who are in good health. Please discuss your need for preoperative testing with your surgeon.

Anticoagulants (blood thinners):

Anticoagulants (blood thinners) usually need to be stopped several days before surgery. Oral medications may need to be replaced with injected or intravenous (IV) medications. It is extremely important that both your surgeon and your physician (who has ordered the anticoagulants) discuss the optimum timing for stopping these medicines. Please be aware that many drugs and herbal products may be anticoagulants (blood thinners) although they are not used for that purpose.

Prescription anticoagulants include:

warfarin (Coumadin)

enoxaparin (Lovenox)

clopidogrel (Plavix)

ticlopidine (Ticlid)

aspirin (in many versions)

non-steroidal anti-inflammatory (NSAIDs) (in many versions)

dipyridamole (Persantine)

Non-prescription (over-the counter or herbal) anticoagulants include:

Aspirin (in many versions)

non-steroidal anti-inflammatory (NSAIDs) (in many versions)

Vitamin E

garlic

ginger

ginkgo biloba

No regional anesthesia (nerve blocks) can be given in the setting of anticoagulant therapy.

Most blood pressure medications should be continued prior to surgery. The exception to this is ACE inhibitors and Angiotensin Receptor Blockers. These medications should not be taken the night before or the day of your surgery. The names of these medications typically end in -pril, -arb, or -artan. Examples of these medications are listed beow:

lisinopril, losartan, benzapril, enalapril, ramipril, olmesartan, valsartan, telmisartan

​In general, blood pressure (heart) medications, anti-seizure medications and acetaminophen-containing pain medications (no aspirin or NSAIDs) should be taken the morning of surgery with a sip of water. Insulin may be given in a reduced dose. Discuss this with your anesthesiologist. Oral hypoglycemic (diabetes pills) should NOT be taken.

Make sure that you inform your surgeon and anesthesiologist that you have the device and bring the information card from your device (brand & model, company contact info). Each device responds differently to the devices we use in the operating room. We may need to have the device interrogated (tested) before or after your surgery, usually within six months of surgery.​

Avoid smoking for 24-48 hours prior to your procedure. There are many reasons to quit smoking as soon as possible and prior to your surgery. Your primary care doctor can help with this process and may suggest prescription or over-the-counter therapies.

Patients who use a CPAP or BiPAP device at home should bring the device to the hospital for use after surgery. It’s best to bring the device with you, even if you plan on returning home on the day of your procedure.

For most procedures at Saint Mary’s Regional Medical Center, your surgeon may arrange for a preoperative evaluation at the STAR Clinic. If there are no concerns or special circumstances surrounding your anesthetic, you will generally meet your anesthesiologist 30-60 minutes before your scheduled surgery time. At that time, your medical history and anesthetic plan will be discussed, and you will have the opportunity to ask questions at that time. If you would like to discuss your care with an anesthesiologist prior to the day of your surgery, please contact us and we will be happy to arrange a phone call regarding your care.

​​We are happy to accommodate requests when possible. However, not all of our physicians are available every day. Please contact our scheduler at 775-770-3209 to make a request.

Being aware or conscious under the effects of anesthesia is one risk of general anesthesia, but with the use of modern pharmacology and monitoring, it is extremely rare. Having some recall of events or circumstances under regional anesthesia or heavy sedation (otherwise known as MAC or monitored anesthesia care) is always possible and should not be considered a failure of these techniques. It is not uncommon for patients to remember “waking up” during previous procedures (such as colonoscopy and wisdom tooth extraction) done under sedation and for a small number of patients, this can be terrifying. Your anesthesiologist will be happy to address any of these concerns and discuss the risks of awareness for your specific anesthetic and surgical procedure.

At Reno Tahoe Anesthesia, we recognize the importance for patients to wake up from surgery as comfortable as possible. Not only is this important for your comfort, but it has also been shown to improve surgical outcomes. In addition to using oral and IV medications to help with post-operative pain, our anesthesiologists are trained in the most up to date techniques using ultrasound guided nerve and fascial plane blocks to provide significant post operative pain relief.

If you plan on going home following your procedure, you must have a responsible adult drive you and stay with you for the entire evening. You must not drive or operate heavy machinery for 24 hours following anesthesia.

We understand that the best healing happens in the comfort of your own home. While we can’t guarantee that your procedure can be done on an outpatient basis, our goal is to get you home as soon as possible. As surgical techniques continue to advance, we are performing more and more procedures on an outpatient basis with tremendous success. Discuss with your surgeon the possibility of performing your procedure on an outpatient basis.

Postoperative cognitive dysfunction (POCD) is primarily a concern for those patients with underlying memory or cognitive deficits. POCD most often involves a subtle decline in memory and the ability to focus. The length of time POCD lasts varies with each individual. Symptoms typically improve over the first week but some cases can persist for months without ongoing illness. The actual cause of POCD is still not clearly understood. There may be some benefit in choosing regional anesthesia over general anesthesia for certain operations and we will be happy to discuss these options with you.

Postoperative nausea and vomiting (PONV) is a common concern for surgical patients. There are many risk factors for PONV including history of motion sickness, female gender, age and certain types of surgery. Unfortunately, we cannot change your risk factors, but we do use several techniques to decrease your risk of developing PONV. The use of one or more anti-nausea medications is part of most anesthetic plans, and in the case of patients at extreme risk of developing severe PONV, we can adjust our anesthetic plan to help minimize the symptoms.