December 5, 2021

Alcohol before surgery: when you need to pause

Alcohol before surgery can make surgery less safe and impair wound healing. Learn when to stop alcohol before surgery for the best cosmetic outcome.

Alcohol has far-reaching effects on the body. It can weaken your body's ability to tolerate surgery; it can also hurt your recovery. Taking a break from alcohol for just a few weeks before surgery can increase your safety.

Alcohol weakens your body's ability to tolerate surgery. It just takes a few weeks of abstinence to normalize, similar to marijuana.

What are the effects of alcohol before surgery?

Even though ethanol was used in ancient times for anesthesia, it was very dangerous. Alcohol affects the body from head to toe:

  • Withdrawal: symptoms begin 24-48 hours after the last drink. This typically falls into the recovery period immediately after surgery.
    • Seizures are the most dangerous withdrawal complications. In fact, withdrawal seizures can be lethal.
    • Other withdrawal symptoms include nausea, vomiting, anxiety, insomnia, agitation, fever, and sweating.
    • Remember, you won’t be drinking alcohol while you recover in the hospital. This puts patients at high risk for alcohol withdrawal after surgery. As such, the earlier you habituate your body, the better.
  • Anesthesia risks: Alcohol increases anesthesia requirements. More anesthesia leads to higher risk. It also leads to higher chance of side effects.
  • Immune system: Alcohol weakens the immune system. This can lead to serious surgical infections.
    • Your immune system also affects wound healing and scar formation.
  • Bleeding: Alcohol can lead to serious bleeding during and after surgery.
  • Heart: Alcohol can weaken heart muscle. This can lead to heart failure, a serious complication during and after surgery.

When should I stop drinking alcohol before surgery?

The negative health effects of alcohol depend on how heavy your drinking is. For example, drinking 3-4 drinks a day has a 50% increased risk for the side effects listed above. This level of drinking includes 7-49% of the population. Unfortunately, heavier drinking (5+ drinks a day) increases risk by 200-400%.

The heavier the alcohol load, the longer you should consider abstaining before surgery. You need to give your body time to recover from the effects of alcohol.

Stopping alcohol 3-8 weeks before surgery can help your body recover to normal.

Stopping alcohol before surgery can have many beneficial effects on the body. The study by Tonnesen outlines the time course of beneficial effects of alcohol abstinence before surgery.
Tonnesen, et al. British Journal of Anaesthesia. (reference below)

Big rewards for your surgical recovery

Preparing for surgery is powerful. Just like preparing to give a speech, the more energy you invest before surgery, the healthier your outcome. Reducing alcohol consumption can make your recovery safer. Moreover, it can also improve your health in the long run.

Alcohol can have serious complications after your operation, too. See my article on alcohol after surgery for an even safer recovery.

As always, discuss your habits with your anesthesiologist before surgery. This will ensure the safest, and most comfortable, experience for you.

References:

Tonnesen H. Alcohol abuse and postoperative morbidity, Dan Med Bull, 2003, vol. 50 (pg. 139-60)

H. Tønnesen, P. R. Nielsen, J. B. Lauritzen, A. M. Møller, Smoking and alcohol intervention before surgery: evidence for best practice, BJA: British Journal of Anaesthesia, Volume 102, Issue 3, March 2009, Pages 297–306

Spies C,  Tønnesen H,  Andreasson S,  Helander A,  Conigrave K. Perioperative morbidity and mortality in chronic alcoholic patients, Alcohol Clin Exp Res, 2001, vol. 25 (pg. 164S-70S)

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