Advice after your nerve block for surgery
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Please refer to specific procedure leaflet (e.g., Endoscopy, Colonoscopy or procedures that require bowel preparation) for more information.
Before your operation or procedure
Please follow the instructions in the table overleaf “What to do with your medication before surgery (or procedure).”
If you take GLP‑1 / GLP-1/GIP receptor agonists (such as liraglutide, dulaglutide, semaglutide or tirzepatide), these are usually continued before surgery. Your anaesthetist will assess any risks and plan your anaesthetic accordingly.
Hypo treatment
If you have any symptoms of a low blood sugar such as sweating, dizziness, blurred vision or shaking, test your blood sugar (if you are able to do so). If it is less than 6mmol/L, take 200mls of a rapid acting carbohydrate drink (non-diet, clear liquid, e.g., Lucozade 200mls). Please tell staff at the hospital that you have done this, in case your surgery may have to be delayed / rearranged for another day
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After your operation (procedure) your blood sugar will be checked and treatment given if required
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After your operation (procedure) you will be offered food and drink when it is safe / you feel able to eat. If you are eating and drinking normally you should resume taking your usual tablets with your next meal. However, your blood glucose levels may be higher than usual for the next 24 hours. If they don’t settle please contact your health care provider for advice.
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When you get home, if you feel nauseated or vomit and are unable to eat, please refer to the Sick Day Guidance
- If you continue to feel unwell for more than 24 hours, please contact your usual health care provider (GP) for advice.
Remember to bring with you to hospital
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A sugary rapid acting carbohydrate drink.
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Blood glucose testing equipment (if you usually monitor your blood glucose). Please note the hospital will monitor your blood glucose.
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Your usual medication.
| Tablets | Day before admission (If not using bowel prep) | Day before admission/day of admission with bowel prep | Day of surgery/procedure | ||
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Patient for a.m. surgery with 6am breakfast (see individual guide) |
Patient for a.m. surgery Nil by Mouth from midnight (see individual guide) |
Patient for p.m. surgery (see individual guide) |
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| Acarbose | Take as normal | Take as normal | Take your morning dose if you are having breakfast before 6 am | Omit morning dose if you have been told to fast from midnight |
Take your morning dose if eating breakfast. Do not take your lunchtime dose |
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Meglitinide (repaglinide or nateglinide) Rybelsus |
Take as normal | Take as normal | Take your morning dose if you are having breakfast before 6 am | Omit morning dose if you have been told to fast from midnight |
Take your morning dose if eating breakfast. Do not take your lunchtime dose |
|
Metformin or Metformin MR If you are due to have contrast media this may need to be stopped on the day of the procedure and not taken for a further 48 hours (your doctor should tell you this advice) |
Take as normal |
If taken once a day – do not stop. If taken twice a day – do not stop. If taken three times a day omit your lunchtime dose only |
If taken once a day – do not stop. If taken twice a day – do not stop. If taken three times a day omit your lunchtime dose only |
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Sulphonylureas (glibenclamide, glipizide, gliclazide/gliclazide MR, glimepiride, gliquidone) |
If no evening meal – Omit | Omit on the morning of surgery. If taken twice daily take evening dose if eating |
Omit on the morning of surgery. If taken twice daily take evening dose if eating |
Omit on the morning of surgery. If taken twice daily take evening dose if eating |
Do not take on day of surgery |
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Thiazolidinediones (Pioglitazone) |
Take as normal | Take as normal | Take as normal | Take as normal | Take as normal |
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DPP-IV inhibitors (sitagliptin, saxagliptin, vildagliptin, alogliptin, linagliptin) |
Take as normal | Take as normal | Take as normal | Take as normal | Take as normal |
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GLP-1 analogue (e.g. exenatide, liraglutide, lixisenatide, semaglutide, dulaglutide) |
As directed by individual anaesthetic risk assessment. Generally, continued as normal. | As directed by individual anaesthetic risk assessment. Generally, continued as normal. | As directed by individual anaesthetic risk assessment. Generally, continued as normal. | As directed by individual anaesthetic risk assessment. Generally, continued as normal. | As directed by individual anaesthetic risk assessment. Generally, continued as normal. |
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SGLT-2 inhibitors (e.g. dapagliflozin, canagliflozin, empagliflozin, ertugliflozin) |
Omit on day before surgery | Omit on day before surgery | Omit on day before surgery | Omit on day before surgery | Omit on day before surgery |
| If your tablet contains two medicines, check whether either needs to be stopped. If so, stop taking the tablet. You should resume taking your normal tablets the morning after surgery (procedure). However, your blood glucose may be higher than usual for a day or so. |
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Contact us
If you have any queries relating to this information, please contact the Diabetes service.
About this information
Service:
Diabetes
Reference:
E/007
Approval date:
16 April 2026
Review date:
1 April 2029
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Important note
This page provides general information only. It is developed by clinical staff and is reviewed regularly every 3 years for accuracy. For personal advice about your health, or if you have any concerns, please speak to your doctor.