Medications to Stop Before Surgery and Nutrition Recommendations

Preoperative preparation is extremely important for performing surgery safely and for a smooth postoperative course. According to the clinical assessments of Prof. Dr. Yavuz Arıkan, this process covers not only the day of surgery, but also the days and even weeks before. The patient’s current health, regular medications, and eating habits are among the factors that directly affect risks during surgery.

Unplanned medication use or incorrect eating habits before surgery can lead to unwanted results such as bleeding, infection, anesthesia complications, and delayed wound healing. Adjusting medications and following nutrition recommendations in the preoperative period are therefore an integral part of the surgical process.

The Importance of Preoperative Medication Review

A large share of patients today use long-term medication because of chronic conditions. Hypertension, diabetes, cardiovascular disease, thyroid disorders, and rheumatic diseases are the most common situations that require regular medication. Painkillers, vitamins, and herbal supplements are also widely used.

As Prof. Dr. Yavuz Arıkan frequently emphasizes in clinical practice, the main aims of medication review before surgery are:

• Reducing bleeding risk during and after surgery

• Identifying medications that may interact with anesthetic drugs

• Controlling medications that may adversely affect heart, kidney, and liver function

• Speeding postoperative recovery

According to Prof. Dr. Yavuz Arıkan, this assessment should be made not only by the surgeon, but together with the anesthesiologist and, when needed, the relevant specialists.

Medication Groups to Stop Before Surgery

Blood Thinners

Blood thinners are the medication group that requires the most attention before surgery. These drugs affect the clotting mechanism and can lead to serious bleeding risk during and after surgery. Commonly used blood thinners include aspirin and aspirin-containing combinations, clopidogrel, warfarin, and newer oral anticoagulants. How long they are stopped can vary with the type of drug, the patient’s additional conditions, and the extent of the planned operation.

In general,

• Aspirin and similar drugs are stopped 5–7 days before surgery

• In patients who use warfarin, INR is monitored and bridging therapy is used when needed

• The stop time for newer anticoagulants is planned according to kidney function

The patient should never decide on their own whether these drugs are stopped or continued.

Painkillers and Anti-inflammatory Drugs

Painkillers are used frequently especially in patients with rheumatic disease and musculoskeletal problems. Nonsteroidal anti-inflammatory drugs can affect platelet function and increase bleeding tendency.

This group of drugs is usually stopped 3–5 days before surgery. It should also be remembered that long-term use can pose a risk for stomach and kidney function. Painkillers containing paracetamol are often considered safer, but preoperative use must still be reported to the physician.

Diabetes Medications and Insulin Use

Preoperative preparation in patients with diabetes requires special planning. Fasting and surgical stress can cause serious fluctuations in blood-sugar balance.

Oral antidiabetic drugs, especially metformin, may therefore be stopped temporarily before surgery because of kidney function and the risk of lactic acidosis. In patients who use insulin, the dose is adjusted on the day of surgery and blood sugar is checked more often.

Blood-Pressure and Heart Medications

Most medications used for hypertension and heart disease are continued before surgery. Some drug groups, however, may be stopped temporarily on the morning of surgery because they can cause low blood pressure during the operation. This decision must be made by the anesthesia and surgical team.

Herbal Products and Food Supplements

Herbal products and vitamin supplements are often seen as harmless, but some of these products can increase bleeding risk and interact with anesthetic drugs. Garlic, ginkgo biloba, ginseng, ginger, and omega-3 supplements are usually recommended to be stopped at least 1–2 weeks before surgery.

The Effect of Preoperative Nutrition on the Surgical Process

Nutritional status is one of the most important determinants of postoperative recovery. In patients who are inadequately or unevenly nourished, infection risk may increase, wound healing may be delayed, and hospital stay may be longer. The patient’s nutritional status is therefore assessed in the preoperative period and diet is adjusted when needed.

Conclusion and Overall Assessment

Medications to stop before surgery and nutrition adjustments are among the cornerstones of surgical success. According to Prof. Dr. Yavuz Arıkan’s clinical approach, patients following physician recommendations fully in this period increases the safety of surgery and affects recovery positively.

The preoperative preparation process should be assessed individually for every patient. Whether medications are stopped or continued should therefore always be discussed with the physician, and nutrition recommendations followed carefully.

Frequently Asked Questions