Dr. Masel holding a child
Surgery and Anesthetic Care

Preparing for your upcoming surgery

Thank you for choosing UTMB for your surgery

We are privileged to be a partner in your care. UTMB clinicians are advocates for your health and have prepared this information to reduce your stress and anxiety as your procedure approaches. Please review this webpage carefully as your surgery date gets closer as it contains critical steps and timelines to prepare for your upcoming procedure.

These guidelines may apply to inpatient care for those admitted to the hospital to stay overnight for extended care, or outpatient treatment, also known as same-day surgery, which includes surgery and other medical procedures that do not require an overnight hospital stay. Day surgery can be convenient and cost-effective, and allows patients to recuperate in the comfort of their own homes.

Preparing for your surgery
Once at the Surgery Center
What to expect at home

If you are scheduled for day surgery, your procedure will be performed at one of the following Outpatient Surgery Units:

Outpatient Surgery Center, Angleton
Outpatient Surgery Center, Galveston
Outpatient Surgery, Clear Lake Hospital
Outpatient Surgery, League City Campus
Endoscopy, Angleton Danbury Hospital
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General Anesthesia Information
 English Anesthesia Pre-op Booklet
 Spanish Anesthesia Pre-op Booklet

Preparing for Your Surgery

  • Notify if Sick

    Circle icon with hospital and sick person symbols

    Be sure to notify your surgeon and anesthesia team (APAC) at (409) 772-6579 if there are any changes in your condition. For example, upper respiratory infections/ productive cough/cold/flu-like illness within the past 2 weeks, recent COVID or flu infection, recent ER visits/ hospitalizations, or new cuts near the surgical site.

  • If you have a pacemaker

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    If you have a pacemaker, your anesthesiologist will need to know if it has been interrogated in the last 12 months.
    If you have an ICD, your anesthesiologist will need to know if it has been interrogated in the last 6 months.
    If your pacemaker or ICD have not been interrogated in the above time frame, arrange to have it interrogated prior to your surgery

  • Increase Movement

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    To prepare your body for surgery, increase movement. Unless told otherwise, walk 20-30 minutes a few days a week to improve heart, lung, and muscle strength.

  • Eat healthy

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    Eat healthy foods to help your body heal faster. Drink plenty of water to improve access to veins and reduce nausea after anesthesia. Reduce caffeine and alcohol, these can cause dehydration.

  • Avoid tobacco

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    Avoid tobacco including vaping, smoking, or chew, to decrease the risk of heart, lung, and wound complications. Certain procedures require a person to quit using tobacco, speak with your surgeon for more details if you smoke.

Medication Instructions

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  • 7 DAYS prior to the procedure
     STOP TAKING
    • Herbal and workout supplements
    • Over the counter medications such as:
      • Fish oil
      • Pain relievers (ex. Aleve, Motrin, Advil, and Ibuprofen, or Aspirin—unless directed otherwise by your surgeon) 
    • Oral weight loss medications (ex. Phentermine, Adipex, Fastin)
     CONTINUE TAKING, as needed
    • Acid reflux medications (ex. Pepcid, Protonix and Prilosec)
    • Tylenol for pain

  • 3 DAYS prior to the procedure
     STOP TAKING
    • Certain diabetes medications that end with “gliflozin” (ex. empagliflozin, canagliflozin, and dapagliflozin. Trade names are Invokana, Farxiga, Jardiance, and several others.) Only stop these types of diabetic medicines. Continue all other diabetic medications.

  • 1 DAY before procedure
     STOP TAKING
    • Long-acting Insulin, take only ½ dose the night before surgery
    • Certain high blood pressure medications called:
      • ACE inhibitors (ex. Benazepril, Captopril, Lisinopril)
      • ARBs (ex. Losartan, Olmesartan, Valsartan)
    • Recreational drugs, alcohol, and tobacco

  • DAY OF PROCEDURE
     STOP TAKING
    • Insulin
    • Oral diabetic medication
    • Diuretics (aka “water pills”)
    • Fiber or bulking agents
    • Medications that require you to take with food or milk
     CONTINUE TAKING, as needed Medications that SHOULD be taken on the day of surgery with a sip of water
    • All other blood pressure medications (excluding those listed above such as ACE Inhibitors and ARB)
    • Asthma Inhalers (bring these with you)
    • Acid reflux medications (ex. Pepcid, Protonix and Prilosec)
    • Clonidine
    • Gabapentin or Lyrica
    • Thyroid medications
    • Regularly scheduled prescribed pain medications such as norco

  • Blood Thinning Medications

    Whether to continue or stop taking your blood thinning/anticoagulant medications is determined by what type of surgery you are having and your surgeon’s preference. You will be instructed by your surgeon regarding stopping blood thinning medications.

What Can I Eat and Drink Before My Surgery?

To ensure your safety during and after anesthesia, please follow these guidelines for eating and drinking in the hours before your procedure.

Stop eating solid foods 8 hours prior to your arrival time.

Stop drinking clear liquids 2 hours before arrival time.

Stop Eating:
Hours Before Arrival Type of FoodExamples
8All other foods and liquidsStop all food 8 hours before procedure, including hard candy, gum, crackers, snack food, fried food, etc. (and chewing tobacco).
6Baby formula 
4Breast milk 
2Clear LiquidsStop all clear liquids 2 hours before procedure. Clear liquids include  water, apple juice and clear, pulp-free juices (no orange juice), black coffee (no milk/creamer/honey), infant electrolyte solutions, soda/sparkling water.
NO MILK, NO FAT, NO PROTEIN
 **CHILDREN AGES 12 and UNDER ONLY** may continue clear liquids until the designated arrival time at the facility.

7 Days Before Your Procedure

Icon with hand clicking yes on a phone screenIf you have not done so already, please complete your anesthesia questionnaire on MyChart. Log into MyChart, go to the menu, and select “Questionnaires.”
Clipboard iconYour Anesthesia Team will review your chart, medical history, and answers submitted on your questionnaire. If further information or clarification is needed based on this review, they will call you the week leading up to your procedure.
Computer monitor with a dollar symbol on screen iconA UTMB surgical coordinator will review financial coverage for your planned surgery and notify you of your out-of-pocket expense prior to your procedure. Financial counseling is available to help you manage your expenses.
Car icon If having same-day surgery, identify a responsible adult (age > 18) who will drive you to and from the surgery center. Taxi, bus, ride services such as Uber, or medical transportation drivers are not considered a responsible escort.
Adult holding child's hand icon If your child is having surgery, one parent cannot come to the hospital with other children. If bringing other children, please have plans for two adults to be present.
Paper and pen iconFollow any other preparation instructions given to you by your surgeon during this time.
Rx iconFollow the instructions noted earlier to stop taking certain medications.

The Day Before Your Procedure

  1. You will receive a phone call from a pre-assessment nurse to let you know where your surgery is scheduled, what time to arrive and provide you with final instructions. Please know that your arrival time is subject to change pending the final OR schedule.
  2. Your surgeon may order medications for you to have after surgery. Do not bring them to the hospital but have them at home for your return.
  3. Follow suggestions from your provider given during your appointment.
  4. Speak with your responsible adult providing a ride to inform them of the arrival time and to verify they are still available.
  5. Avoid drinking any alcohol or using any tobacco products including chew, cigarettes, and vaping on the day of your surgery.
  6. Bring your current medication list (leave the medications at home, except your inhalers) and any pacemaker or internal defibrillator cards, if applicable.
  7. Take a shower the evening before or the morning of surgery while following any wound preparation instructions you were given such as using an antimicrobial soap like Dial or Hibiclens. Do not shave the operative area. Do not apply lotions or creams.

The Day of Your Procedure

  1. Be sure to pack any glasses, hearing aid, or dental cases for use on day of surgery.
  2. If being admitted, you may bring a few comfort items such as robes, house shoes, and toiletries. Please bring your CPAP or BiPAP along with any tubing in a carrying case.
  3. Before leaving home, take any medications that have you have not been asked to stop with a sip of water. Bring your inhaler(s) with you. Leave the rest of your medications at home.
  4. Leave all valuables at home. Each facility is different and there may not be a safe place to store items such as your wallet or phone during your procedure.
  5. Shower if you have not done so the night before. Follow instructions above.
  6. Brush your teeth, but do not swallow the water.
  7. If menstruating, do not wear tampons. Use pads.
  8. Wear comfortable clothing that would be easy to take on and off based on your planned surgery site.
  9. Remove any jewelry including body piercings.
  10. Do not wear contacts. Your glasses will be placed with your clothing once you go into surgery. They will be given to your family or stored.
  11. You may wear your hearing aids until you go into surgery. Your hearing aids must then be placed with your other belongings.
  12. You may continue to drink clear liquids including water, apple juice, and clear, pulp-free juices (no orange juice), black coffee (no cream/ milk), Gatorade, or Pedialyte up to 2 hours before your arrival time.
  13. Arrive at your surgery center location at your scheduled arrival time.

Once at the Surgery Center

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  • At arrival

    You will be greeted by our Day Surgery team who will ask you to change into a hospital gown. No personal clothing/items will be allowed into the operating room.

    This team will also perform a brief assessment including taking your vital signs and reviewing your medical history including your, medications, and allergies. We will ask you about your preference for a pharmacy; please ensure that the pharmacy information we have for you is accurate. An IV catheter will be placed and any necessary lab work will be drawn at this time. A urine sample may be requested, if needed. (Pediatric patients— see pediatric section.)

    You will meet your anesthesia team in the pre-op area to discuss your medical history and review your personal anesthesia care plan. The team will discuss the risks and benefits of anesthesia with you. We encourage you to ask questions and provide input. A copy of the anesthesia consent form is attached to this document for your review prior to arrival.

    You will also visit with your surgery team in the pre-op area to discuss any changes to your health, address any questions you might have, and review your plan of care.

    During your visit you will be asked some of the same questions multiple times as part of our quality assurance and safety program.

  • During your procedure

    Your anesthesia, nursing, and surgery team will be by your side to monitor you, make sure you remain safe and comfortable, and work to minimize any side effects.

    Your family or escort must wait in the designated waiting room and will be updated when the procedure is completed (if authorized by you). There are TV monitors in the area that provide updates on your phase of care and location using a code given to your family/escort in pre-op area.

  • After Your Procedure

    You will be taken to the recovery room where a team of nurses and physicians will monitor you.

    Your comfort is important to us. Please let the nurses know if you experience pain or nausea so they can help. Please know that after surgery, it is not always possible to control all pain, but we ask that you help us find a level that is tolerable for you.

    The team will contact your family or escorting adult when you have recovered sufficiently enough to have your support person visit you in recovery.

    Being discharged to home will depend on your type of procedure, your vital signs, and your pain control. Before leaving you will be given discharge instructions about how to care for yourself post-procedure and what to do if you have any concerns or start to feel unwell.

Doctor looking at patient who is prepped for surgery

What to expect at home

  • It is advisable that a responsible adult stay with you the first 24 hours to assist you. Avoid making important decisions, driving, or performing activities that require fine motor skills until you return to your normal self.
  • Take your postoperative pain medications as directed by your surgeon. Do not overuse your pain medication as this could cause serious health issues. Pain medications can often cause constipation. Be sure to take a stool softener, as directed by your surgeon.
  • Monitor your incision site, as able. Do not remove dressings until instructed by your surgeon. Care for your wound as directed by your surgeon. Report any unusual discharge, redness, and pain to your surgeon’s office. You will be given the phone number to the clinic to which you can direct questions and receive additional information or instructions.
  • A RN will contact you within a few days of your surgery to see how you are doing.
  • Please follow any activity limitations and perform rehabilitation exercises as instructed.
  • Return for any scheduled follow up appointments.

General Information About Anesthesia  Person with a breathing mask on icon

General Anesthesia

1
General Anesthesia provides a total loss of consciousness, meaning you will be “fully asleep.” You will not be aware of any pain or feeling during your procedure. This type of anesthesia uses a combination of medicine given through your IV and/or breathed in anesthesia gases.

Monitored Anesthesia Care

2
Monitored Anesthesia Care (MAC) utilizes IV medication to help you relax and decrease pain. You will not be completely asleep during your procedure but we will ensure you are comfortable and relaxed.

Regional Nerve Block

3
Regional Nerve Block produces loss of pain and sensation to the specific part of your body where the surgery will take place. Your anesthesiologist will give you an injection of medication near a nerve to achieve this. This may be used alone or in combination and can help keep you comfortable during and after surgery.

Pediatric Procedures

We understand that going through a surgical procedure can be unsettling for children and their families. We want to assure you that your child will be in experienced and caring hands. Our pediatric clinicians have completed specialty training in pediatric care, including pediatric fellowships, which makes them uniquely qualified to care for your children.

An anesthesiologist will conduct a preoperative interview and discuss the anesthetic plan with you. A safety check will be performed with you and your child in the holding area with the anesthesiologist, surgeon, and nursing team present. During this safety check, we will address any concerns and ensure that we have the best possible plan for your child. Some children may receive oral anti-anxiety medicine prior to going to the operating room.

After surgery, your child will awaken in the recovery room where the nurses will monitor your child’s vital signs and comfort level. Children benefit from familiar surroundings so you will be brought in as they begin to wake up.

 Anesthesia Consent Review prior to the day of surgery

Contact Anesthesia Pre-Op Assessment Clinics

Angleton Danbury (979) 864-8495
Clear Lake (832) 632-7396
Galveston (409) 772-6579
League City (409) 772-6579

Contacts & Resources

Important Numbers

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Patient Resources

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