Preparing for IV Sedation or General Anesthesia
Medically reviewed by Dr. Sergio Calleja, DDS, MPH — Board-Certified Oral & Maxillofacial Surgeon · Last reviewed 2026-07-02
Our practice offers IV sedation ("twilight sedation") and general anesthesia in the office for patients who want or need to sleep through their procedure. Anesthesia is extremely safe when the rules are followed — and the rules exist for exactly one reason: your safety.
This page explains each requirement and why it matters. Your written pre-anesthesia instructions, confirmed when your surgery is scheduled, always take priority over this general guide.
The Fasting Rule — the One That Cannot Bend
An empty stomach is the foundation of anesthesia safety. While sedated, the reflexes that normally protect your airway are relaxed; anything in your stomach could come up and reach your lungs. This is why fasting is non-negotiable and why we will always ask.
Typical instructions are no food or drink — including water, gum, mints, and candy — for at least 8 hours before your appointment, often phrased as "nothing after midnight" for morning surgery. Some patients may be told that small sips of clear water are permitted up to a specific cutoff; your written instructions state your exact window. If you eat or drink inside your fasting window, tell us honestly — we will reschedule rather than take a risk, and no one will scold you.
Medications: What to Take, What to Pause
Review every medication and supplement with us before surgery day. General principles — your written plan governs:
- Most daily medications (for example blood pressure medicine) are taken as usual with a small sip of water — but only if we have told you to
- Blood thinners (warfarin, Eliquis, Xarelto, Plavix, daily aspirin): never stop these on your own; we coordinate any pause with your prescribing physician
- Diabetes medications and insulin often need adjustment because you are fasting — we will give you a specific plan
- GLP-1 medications (Ozempic, Wegovy, Mounjaro, Zepbound and similar weekly injections): tell us at the consultation — these slow stomach emptying and change modern anesthesia planning, sometimes requiring the dose to be held or fasting extended
- Bring your complete medication list, including doses, to every visit
Your Escort: A Requirement, Not a Suggestion
A responsible adult must drive you to the appointment, remain reachable during the procedure, drive you home, and stay with you afterward. Sedation medications impair judgment, coordination, and memory for hours after you feel "normal" — you may not drive, work, sign documents, or be responsible for others for the rest of the day.
A rideshare or taxi driver alone does not qualify — the requirement is a responsible adult who takes charge of you. If your escort falls through, call us and we will re-plan together.
What to Wear and What to Skip
- Loose, comfortable clothing with short sleeves or sleeves that roll up easily — the IV goes in your arm and monitors go on your skin
- Flat, secure shoes — you will be walking out with support while still a little unsteady
- No contact lenses (wear glasses), no jewelry or piercings, no heavy makeup
- Keep at least one fingernail free of polish or acrylic — the small clip on your finger reads your oxygen level through the nail
- Skip perfume, cologne, and heavy lotions on surgery day
Health Changes and Habits Before Sedation
- Report any cold, cough, fever, or new illness in the days before surgery — respiratory symptoms in particular can make sedation unsafe and may require rescheduling
- No alcohol for at least 24 hours before anesthesia
- No smoking or vaping on the day of surgery — ideally longer; it irritates the airway and impairs healing
- Tell us about any past anesthesia problems, in you or your blood relatives
- If there is any chance of pregnancy, tell us before surgery day
The 24 Hours After Sedation
Plan for a genuinely quiet day. You will be drowsy and may remember little of the hours after surgery — that is normal. For the rest of the day: no driving, no work or school, no important decisions or documents, no alcohol, and no being the responsible adult for children or dependents. Rest, hydrate, follow your post-surgery instructions, and let your escort handle logistics. Most patients feel clear-headed again by the next morning.
Call Us If
- You ate or drank inside your fasting window — honesty keeps you safe
- You develop a cold, cough, or fever before surgery
- You are unsure about any medication — including whether to take it the morning of surgery
- Your escort plans change
- You have had a problem with anesthesia before and have not yet told us
Office: (301) 645-6911 (Waldorf) · (301) 863-8107 (California, MD). For emergencies, call 911.
Frequently Asked Questions
Why can't I eat or drink before sedation?
Sedation relaxes the reflexes that protect your airway. If anything is in your stomach, it can come up silently and enter your lungs — a serious complication called aspiration. An empty stomach removes that risk entirely, which is why the fasting rule has no exceptions.
Can I drink water before IV sedation?
Follow your written instructions exactly. The typical rule is nothing by mouth — including water — for at least 8 hours before surgery; some patients are given a specific earlier cutoff for small sips of clear water. If your instructions do not mention water, assume it is included in the fast and call us to confirm.
What is the difference between IV sedation and general anesthesia?
IV sedation ("twilight sedation") keeps you in a deeply relaxed, sleepy state — you breathe on your own and respond to voice, but most patients remember nothing. General anesthesia takes you fully asleep. Dr. Calleja recommends the level that fits your procedure, health history, and preference, and both are provided with full monitoring.
Do I need to stop Ozempic or other GLP-1 medications before anesthesia?
Tell us about GLP-1 medications (Ozempic, Wegovy, Mounjaro, Zepbound and similar) at your consultation. Because they slow stomach emptying, current anesthesia guidance may require holding a dose before surgery or extending your fasting window. We will give you a specific written plan — do not adjust the medication on your own.
Can I take an Uber home after sedation?
Not alone. You need a responsible adult who takes charge of you — drives or accompanies you home and stays with you. A rideshare driver cannot fill that role. If arranging an escort is difficult, call us and we will figure out a plan together before surgery day.
How long until I feel normal after IV sedation?
Most patients feel back to themselves by the next morning. For the rest of surgery day, expect drowsiness and patchy memory — no driving, working, or important decisions until the following day.
Is IV sedation safe for oral surgery?
Yes — office-based anesthesia by oral & maxillofacial surgeons has a long, well-documented safety record. OMS training includes dedicated hospital anesthesia rotations, and your heart rate, blood pressure, breathing, and oxygen levels are continuously monitored by a trained team throughout the procedure. The preparation rules on this page are a core part of that safety system.
Questions About Your Surgery?
Our team walks every patient through preparation and recovery — call us or send a consultation request.
Related Guides
This page is general patient education, not personal medical advice. The written instructions provided for your specific procedure always take priority. For emergencies, call 911.