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Pre-Surgery Instructions for UPMC in Central Pa.

Following these pre-surgery instructions will help you prepare for a smooth and safe procedure.

Before Your Surgery Approximately Seven Days Prior to Your Surgery

Approximately one week prior to your surgery, a member of the preadmission department will call you to complete your medical history and obtain a list of your medications. If you are taking a blood thinner, on aspirin products, ibuprofen, Motrin, Plavix, NSAIDS, GLP-1 medications, and/or SGLT-2 medications and you have not received instructions from your prescribing provider and/or surgeon on when or if to discontinue prior to your surgery, please call them today to receive those instructions.

One Business Day Prior to Your Surgery

On the business day prior to your surgery, a member of the preadmission department will call you to provide your surgery time, arrival time to the hospital, and all final instructions. The Preadmission testing department makes calls up until 7pm the business day prior to surgery. Please do not call the preadmission testing department or the hospital operating room for your arrival time, they will contact you.

Preadmission Testing UPMC Hanover Phone: 717-316-3617 Hours: 8 a.m. to 4:30 p.m., Monday through Friday

Preadmission Testing UPMC Lititz Phone: 717-625-5890 Hours: 8:00 a.m. to 4:30 p.m., Monday through Friday

Preadmission Testing UPMC Memorial Phone: 717-849-2350 Hours: 8 a.m. to 4:30 p.m., Monday through Friday

Preadmission Testing UPMC Carlisle, Community Osteopathic, Harrisburg, Outpatient Surgery Center - Carlisle, and West Shore Phone: 717-230-3461 and choose correct option Hours: 8 a.m. to 6 p.m., Monday through Friday 

Pre-Surgery Fasting

Patients coming in for surgery/procedures should not have anything to eat or drink after midnight the night prior to surgery unless otherwise instructed by the preadmission testing department the business day prior to surgery.

About Medications

In general, you can take all medications, including pain and acid reduction medications as well as beta-blockers, early in the morning of your surgery with a small sip of water. Please note the following exceptions:

PATIENTS SHOULD NOT take the following medicines unless otherwise instructed by the prescribing physician or the surgeon: Patients MUST discuss stopping these medications with the prescribing provider as some should not be stopped abruptly:

  • ACE Inhibitors (for example, Lisinopril, Enalapril, Quinapril, etc.)- should NOT be taken the morning of surgery.
  • Angiotensin Receptor Blockers (ARBs) - (for example, losartan, valsartan, Benicar, Cozaar, etc.) should NOT be taken the morning of surgery.
  • Blood thinners – including but not limited to: aspirin products, ibuprofen, Motrin, Plavix, Eliquis, Warfarin and NSAIDS should be stopped one week prior to surgery unless otherwise instructed by the prescribing physician or the surgeon.
    • ASA 325 mg- prefer stopped for 7 days unless ok’d by surgeon.
    • ASA 81 mg – prefer stopped 7 days - OK if not stoppen.
    • NSAIDS-prefer stopped for 7 days unless ok’d by surgeon.
    • Plavix- prefer stopped for 5-7 days unless ok’d by prescribing provider.
    • Effient – must stop 5-7 days.
    • Warfarin- must stop 5-7 days.
    • Xarelto – must stop 24hrs.
    • Eliquis – must stop 72hrs.
    • Pradaxa.
      • must stop 4 days prior if Creatinine Clearance > 3.
      • must stop 6 days if creatinine Clearance < 3.
  • Buprenorphine (e.g., Suboxone, etc.) requires a formal review and specific considerations prior to surgery. Usually this involves the development of a Suboxone plan between the prescriber, anesthesiologist, surgeon and patient. This plan can take up to one to two weeks to formalize. Please notify the Surgery Optimization Clinic as soon as possible if the patient is taking this medicine.
  • Diuretics also known as “water pills” (for example, furosemide, and hydrochlorothiazide) should NOT be taken the morning of surgery. 
  • IM Vivitrol – patient must wait 6 weeks after last dose before having surgery.
  • Oral diabetes medications in the SGLT-2 Inhibitor Class (for example, Canagliflozin (Invokana), Dapagliflozin (Faxiga), Empaglifozin (Jardiance), Ertugliflozin (Steglatro), Glyxambi, Synjardy, Xigduo XR) must be stopped 3 FULL days prior to surgery. Patient should call diabetic care provider for additional instructions for managing diabetes prior to surgery. This applies to all surgical and endoscopy cases.
  • MAO Inhibitors (for example, Nardil and Parnate) must be stopped two weeks prior to surgery.
  • Vitamins, herbals, dietary supplements (except for Vitamin D, Magnesium, Calcium and Probiotics – these are permissible to take up until day of surgery) - prefer stopped for 14 days prior unless Ok’d by prescribing provider.
  • GLP-1 agonists (used for Diabetes and weight loss):
    • a. Hold GLP-1 agonists on the day of the procedure/surgery for patients who take the medication daily. (i.e., Adlyzin, Victoza, Saxenda, Byetta)
      • Rybelsus is the exception to this. Due to the prolonged half-life, Rybelsus should be stopped 7 FULL days prior to the procedure/surgery
    • b. Hold GLP-1 agonists 7 FULL days prior to the procedure/surgery for patients who take the medication weekly. (i.e., Bydureon, Ozempic, Trulicity, Wegovy, Tanzeum, Mounjaro, Zepbound)
    • c. Patients should consult with their endocrinologist and/or PCP for guidance for diabetes management to help control their condition and prevent hyperglycemia.

Transcatheter aortic valve replacement (TAVR) patients should NOT take their beta blockers the morning of surgery.

For patients who have diabetes, it is best to receive instructions from your physician who prescribes your diabetic medication. Instructions will be reviewed during your pre-op phone call to discuss the medications you should take the evening before and the day of surgery.

Cardiac Surgery Patients: Please follow all medication instructions as outlined by the surgeon's office.

Medical Marijuana: Federal law still prohibits the possession and utilization of marijuana in any form, under any circumstance. Therefore, UPMC prohibits the possession and utilization of marijuana in any form (including CBD oil) on UPMC property. If you are prescribed medical marijuana, please do not bring it to the hospital. Please discuss with your surgeon and or prescribing provider an appropriate alternative.

For patients who have diabetes: the Preadmission Testing department will review instructions during the preop phone call the evening prior to surgery.  Nurses will discuss the medications the patient should take the evening before and the day of surgery unless otherwise instructed by the prescribing provider or surgeon.

Other Reminders

  • Please bring your current medication list to the hospital.
  • Arrange for an adult friend or relative to drive you home after the surgery or procedure. You may not drive yourself home or take public transportation (bus, taxi, Uber) without a responsible adult to accompany you after receiving anesthesia. 
  • Money, credit cards, or other valuables should be left at home. 
  • Please remember to bring your insurance cards and photo ID. 
  • Leave all of your regular medications at home, unless your physician specifically asks you to bring them.
  • If you use a CPAP machine, please bring your machine (mask, tubing, etc.) with you on the day of your surgery/procedure 
  • If advised, bring any inhalers and eye drops along with you and give them to your nurse when you arrive. 
  • For your safety, it is recommended that you have a responsible adult staying with you overnight after your surgery.
  • Two adults may accompany children who are having outpatient surgery. Please do not bring children other than the patient.
  • UPMC does not accept responsibility for the loss of or damage to any belongings brought into the hospital except for those that have been deposited in the hospital safe. Patients are urged to leave articles at home that they consider to be of personal value. Belongings that are retained at the bedside are the sole responsibility of the patient. 
  • Since eyeglasses, contact lenses, prosthesis, and dentures must be removed before surgery, please remember to bring protective containers. Please bring your own contact solution. 
  • Jewelry and body piercings may increase a patient's risk of surgical burns from the medical equipment used during surgery. All jewelry, including piercings of any type, i.e. any skin piercings or dermals, and your wedding band, must be removed. If your wedding band cannot be removed, please go to a jeweler to have it removed. 
  • Shower or bathe and brush your teeth as usual the morning of surgery. Please swish and spit, do not drink. 
  • Please do not wear lotion, powder, deodorant, makeup, or alcohol-based hair product (e.g., gels, hairspray).
  • Wear loose, comfortable clothing and shoes with flat heels. 
  • Do not smoke after midnight prior to your surgery or procedure.
  • If you are staying overnight, please leave large items like suitcases or walkers in your car until you have been assigned a room. A family member will need to retrieve them later.
  • Breastfeeding mothers should bring their own breast pumps to the hospital.

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