Hysterectomy Surgery Day: Anesthesia, Nausea, How Long It Takes and Going Home

The day of a hysterectomy is long, and much of it is spent waiting: checking in, changing, answering the same safety questions several times, and then waking up in a room you do not remember arriving in. Knowing the order of events makes it easier to stay calm, to tell the team what they need to know, and to plan the trip home.

This guide walks through a typical surgery day in a US hospital: fasting and medicines that morning, meeting the anesthesia team, the types of anesthesia used, how long the operation usually takes, what waking up feels like, how to prevent and manage nausea, and what has to happen before you can go home. It is based on patient information from MedlinePlus, the American Society of Anesthesiologists (ASA), the NHS and the Royal College of Obstetricians and Gynaecologists (RCOG), plus published guidelines and studies. For the weeks before surgery, see how to prepare for a hysterectomy, and for your bag, our hospital packing checklist.

Key points

• You may be asked to arrive up to 2 hours before your operation. Follow your hospital’s fasting instructions exactly; many hospitals now allow clear liquids until about 2 hours before.^[1][3]
• Most hysterectomies are done under general anesthesia. A vaginal hysterectomy can sometimes be done under spinal anesthesia instead.^[6]
• The operation itself often takes about 1 to 2½ hours, depending on the approach and how complex it is, but the whole day is much longer.^[6][7][8]
• Women are at higher risk of nausea after anesthesia. Telling the team about past nausea or motion sickness lets them give preventive medicine.^[13][14]
• Many people go home the same day or the next day after a laparoscopic, robotic or vaginal hysterectomy; open surgery usually means a few nights in hospital.^[8][11][19]
• You cannot drive yourself home, and an adult should stay with you for at least the first 24 hours after a general anesthetic.^[10][12]

Surgery day at a glance

Every hospital runs its day a little differently, but the order is usually the same:

1. Arrival and check-in, often early in the morning and up to 2 hours before surgery.^[1]
2. Getting ready: gown, ID bracelet, safety checks, an IV line and vital signs.^[1]
3. Meeting the anesthesia team and, usually, a quick visit from your surgeon.^[1]
4. The operating room: the anesthesia starts, then the operation.
5. The recovery room, where you wake up and are watched closely for a few hours.^[10]
6. A hospital room or home, depending on your surgery and how you feel.^[1][10]

Before you leave home: food, drink and medicines

Eating and drinking

Your stomach needs to be empty for anesthesia, so that nothing can come back up into your lungs while you are asleep. You may be told not to eat or drink after midnight, or you may be allowed clear liquids and your regular medicines until a set time.^[1][2] MedlinePlus notes that some people can have clear liquids until 2 hours before surgery.^[1]

Some hospitals also give a clear carbohydrate drink a couple of hours before surgery as part of an enhanced recovery program. The ASA’s 2023 fasting guideline says healthy adults can have carbohydrate-containing clear liquids up to 2 hours before an elective operation.^[3] Rules still differ between hospitals, so follow the written instructions you are given, not general advice. If you eat or drink outside the agreed times by mistake, tell the team when you arrive rather than hiding it: it may delay your operation, but it keeps you safe.

Your usual medicines, supplements and weight-loss injections

Before surgery day, give the team a list of every prescription and over-the-counter medicine, vitamin and supplement you take. The anesthesiologist may ask you to stop some of them first.^[2] If you have been told to take a medicine on the morning of surgery, take it with a small sip of water.^[1]

If you use a GLP-1 medicine such as semaglutide (Ozempic, Wegovy) or tirzepatide (Mounjaro, Zepbound), say so well in advance. These drugs slow stomach emptying. Guidance published in 2024 by the ASA and four other societies says most people can keep taking them, but those at higher risk may be asked to follow a liquid diet for 24 hours before surgery or to take other precautions.^[4] Do not stop or change the dose on your own; ask your surgeon or anesthesia team what to do.

What to wear and leave at home

MedlinePlus advises loose, comfortable clothes and flat shoes; no contact lenses, makeup, lotion, deodorant or perfume; jewelry and piercings removed; and valuables left at home. Bring your ID, insurance card, a list of medicines and any equipment you use, such as a CPAP machine or a cane.^[1] The full list is in our packing checklist.

Checking in and getting ready

Once you arrive, a nurse will take you to a pre-operative area. You will change into a gown and cap, get an ID bracelet, and be asked to confirm your name, date of birth and the operation you are having, often several times. This repetition is a safety check, not a sign that anyone is confused. A nurse will put in an IV line and check your blood pressure, pulse and temperature.^[1] Many hospitals also give you compression stockings or leg sleeves to help prevent blood clots.

This is usually when family or a friend can sit with you. After you go into the operating room, ask the staff how and when your companion will get updates.

Meeting the anesthesia team

On the day of surgery you will meet the anesthesia providers who will look after you during the operation.^[1] In the US this may be an anesthesiologist (a doctor) working with a nurse anesthetist or anesthesiologist assistant. They will go over your health, check when you last ate and drank, and explain the plan.

This is the moment to mention anything that could change their plan. The ASA asks patients to report:^[2]

• Any bad reaction to anesthesia or pain medicine, in you or a family member, even if it happened years ago.
• Snoring or other sleep problems, which can be signs of sleep apnea and make anesthesia riskier.
• All medicines and supplements you take.

Also tell them if you have felt sick or vomited after a previous operation, or if you get motion sickness. These are two of the strongest predictors of nausea after anesthesia, and knowing about them helps the team decide how much preventive medicine to give.^[13][14]

Which type of anesthesia will you have?

The choice depends on the type of operation, your health and, where there is a real choice, your preference.^[5]

• General anesthesia: you are fully unconscious and a machine helps you breathe through a tube or airway device. It is used for laparoscopic (keyhole), robotic and abdominal (open) hysterectomies.^[5][6]
• Spinal or regional anesthesia: an injection in your back numbs you from the waist down while you stay awake or lightly sedated. The NHS notes that a vaginal hysterectomy can be done under general, spinal or local anesthesia.^[6]
• Extra numbing: many teams also inject local anesthetic around the incisions or use nerve blocks to reduce pain afterwards and cut down on opioids. Enhanced recovery guidance from the American College of Obstetricians and Gynecologists (ACOG) encourages regional and non-opioid pain relief where possible.^[17]

If you are anxious about being awake, or about being put to sleep, say so. With spinal anesthesia, you can usually also be given sedation so that you are drowsy and relaxed; ask what your options are.

How long does a hysterectomy take?

The NHS says a vaginal or abdominal hysterectomy usually takes about an hour.^[6] Keyhole surgery tends to take longer: a Cochrane review found that laparoscopic hysterectomy had a longer operating time than both vaginal and abdominal surgery.^[9] In the large UK eVALuate trials, laparoscopic operations averaged 72 to 84 minutes, against 39 to 50 minutes for vaginal or open surgery.^[7] In a series of more than 1,000 laparoscopic hysterectomies in a US health system, the median surgical time was 150 minutes.^[8] A large uterus, scar tissue from earlier operations, endometriosis or removal of other organs can all add time. For more detail on keyhole surgery, see our guide to laparoscopic hysterectomy.

Type of hysterectomy	Usual anesthesia	Typical operating time	Typical hospital stay
Vaginal	General or spinal[6]	About 1 hour[6][7]	Often home the next day[19]
Laparoscopic or robotic	General[6]	About 1 to 2½ hours[7][8]	Same day or next day[8][15][19]
Abdominal (open)	General[6]	About 1 hour[6][7]	Usually 1 to 4 days[19][20]

The operating time is only part of the wait. Your family should expect you to be away for longer, because the anesthesia has to be started before surgery, and you then spend time in the recovery room, often a few hours, before moving to a ward or getting ready to go home.^[10] A longer wait than expected is common and does not by itself mean something has gone wrong; the team can tell your companion how things are going.

Waking up in the recovery room

After surgery you are moved to a recovery room, where nurses and the anesthesia team keep checking your breathing, heart and pain.^[10] The NHS says it is normal to wake up tired and in some pain.^[11] You may have:^[11]

• A drip (IV) in your arm for fluids and medicines.
• A catheter draining urine from your bladder.
• Dressings over small cuts on your belly, or over a longer incision after open surgery.
• After a vaginal hysterectomy, a gauze pack in the vagina for about 24 hours to reduce bleeding.
• After an abdominal hysterectomy, sometimes a drain in the belly for a day or two.

Common short-term effects of general anesthesia include drowsiness, a sore throat or hoarse voice from the breathing tube, thirst, shivering and feeling sick. Some people feel confused for a while, especially older patients. These effects usually ease within minutes to hours.^[10][12] After keyhole surgery, the gas used to inflate the belly can cause bloating and a sharp ache in one or both shoulders for a day or two; walking and regular pain relief help. Our guide to swelly belly explains why.

Tell the nurse straight away if your pain is not controlled or you feel sick. Both are easier to treat early than once they are severe.

Nausea and vomiting after anesthesia

How common it is, and who is most at risk

Feeling sick after surgery is one of the side effects people dread most, and gynecological surgery carries a higher risk than many other operations. A widely used risk score, developed by Apfel and colleagues, counts four factors: being female, not smoking, a history of motion sickness or of nausea after previous surgery, and needing opioid painkillers after the operation. In the original study, without preventive medicine, the chance of nausea or vomiting in the first 24 hours rose from about 10% with none of these factors to about 39% with two and 79% with all four.^[13]

Since most women having a hysterectomy already have one or two of these factors, anesthesia teams expect nausea and plan for it.

What the team can do

International consensus guidelines, endorsed by more than 20 professional societies, recommend assessing each patient’s risk and giving preventive anti-sickness medicines, often two or more different ones together, to people with risk factors. They also cover ways to lower the baseline risk, such as using regional anesthesia and keeping opioids to a minimum, and how to treat nausea that breaks through.^[14] You do not need to know the drug names; you just need to make sure the team knows your history.

What you can do

• Speak up early. Mention past nausea or motion sickness before surgery, and ask for anti-sickness medicine as soon as you start to feel queasy afterwards. The NHS notes that the nurse can give medicine for it.^[11]
• Start eating and drinking when you are offered food. The RCOG says eating early after surgery is safe and that you are less likely to feel sick.^[15] Start with sips and something plain.
• Move slowly. Sit up and stand in stages, with help, especially the first time.
• Keep pain under control. Pain itself can make nausea worse, and good non-opioid pain relief can reduce how much opioid you need.^[14][17]

Nausea after you get home

Nausea does not always stop when you leave. In a US study of more than 2,000 adults going home on the day of surgery after general anesthesia, 37% had nausea or vomiting at some point in the first two days after discharge. Being female, under 50, a history of nausea after anesthesia, opioids in the recovery room and nausea in the recovery room all raised the risk.^[16] If you have had bad nausea before, ask whether you can take anti-sickness medicine home. Call your surgeon if you cannot keep food or drink down.^[22]

Getting up, eating and the catheter

Modern “enhanced recovery” programs aim to get you back to normal quickly: shorter fasting, eating and drinking soon after surgery, getting up and walking early, and pain relief that relies less on opioids. ACOG and the ERAS Society both support these steps, which are linked to shorter hospital stays, less pain and a faster return of bowel function.^[17][18]

• Getting up: staff will help you out of bed to sit in a chair and then walk short distances, often on the day of surgery or the next morning. Moving early lowers the risk of blood clots in the legs.^[11][15][19]
• The drip is usually taken out once you are eating and drinking.^[15]
• The catheter usually stays in for up to 24 hours, and is often removed before you leave hospital.^[15][19] Some people have trouble emptying their bladder at first; the team will usually check that you can pee before you go home. Our guide to bladder problems after a hysterectomy explains what is normal.
• Bowels: passing gas is a good sign that your bowels are waking up. A first bowel movement often takes a few days; see constipation after a hysterectomy.

Going home the same day or staying overnight

How long you stay depends on the type of surgery, your health, the time of day you finish and how you feel. MedlinePlus says most people go home the next day after a vaginal, laparoscopic or robotic hysterectomy, and after 1 to 2 days following an abdominal one (longer if the surgery was for cancer).^[19] The RCOG says most women go home 2 to 4 days after an abdominal hysterectomy, and that after a laparoscopic one some go home within 24 hours while others stay 1 to 3 days.^[15][20]

Same-day discharge

Going home on the day of a laparoscopic hysterectomy is now routine in many US hospitals for carefully selected patients. In a Kaiser Permanente series of 1,015 laparoscopic hysterectomies, 52% of patients went home the same day. Only 0.6% of them were readmitted within 48 hours, and fewer than 4% came back for emergency care in the first 2 to 3 days, most often for nausea or vomiting, pain or trouble passing urine.^[8] In a Dutch randomized trial of 205 women having laparoscopic hysterectomy for non-cancerous or precancerous conditions, those sent home the same day recovered physical function as well one week later as those who stayed one night.^[21]

Even if same-day discharge is the plan, it can change if surgery finishes late, you are sick or in pain, or you cannot pee. Pack for at least one night.

What has to happen before you can go home

You will not be discharged until you are ready, whatever the planned date. The RCOG describes “ready” as being able to move around, eat and drink, and control your pain with tablets.^[15][20] In practice, most teams also want to see that:

• You have passed urine after the catheter came out.^[8][19]
• Nausea is controlled and you can keep fluids down.
• Your bleeding is light.
• You have your medicines, written instructions and a number to call.^[20]
• An adult is there to take you home.^[10][12]

The ride home and the first night

For at least 24 hours after a general anesthetic, the NHS advises that you should not drive, drink alcohol or make important decisions, and that someone should collect you from hospital and stay with you.^[12] The ASA also recommends having someone with you for at least the first 24 hours, and not driving while you are taking opioid painkillers.^[10] If you live alone, arrange for someone to stay with you for the first few days.^[15]

• In the car: a small pillow between the seatbelt and your belly can make bumps easier to bear. When you will be able to drive again yourself is covered in when can I drive, fly or take a bath after a hysterectomy.
• Pain relief: take your medicines as prescribed, especially the first night. MedlinePlus notes many people need pain medicine regularly for the first two weeks.^[22]
• Walk a little: short walks around the house every few hours help your circulation, gas and bowels.^[22]
• Sleep: lying on your back with a pillow under your knees, or propped up, is often most comfortable. See how to sleep after a hysterectomy.
• Some spotting is normal: light vaginal bleeding or discharge is common in the first days. Our guide to bleeding after a hysterectomy explains what is normal.

For what the following days and weeks usually look like, see hysterectomy recovery week by week.

Warning signs after you get home

Call 911 if you have chest pain, sudden shortness of breath, coughing up blood, fainting, or very heavy vaginal bleeding.

Call your surgeon the same day if you have any of these:^[22]

• A fever above 100.5°F (38°C).
• Pain that your pain medicine is not controlling.
• Nausea or vomiting, or being unable to eat or drink.
• Being unable to pass urine, or pain or burning when you pee.
• Being unable to pass gas or have a bowel movement.
• Vaginal bleeding heavier than light spotting, or a heavy, watery or bad-smelling discharge.
• Bleeding, redness, warmth or thick yellow or green drainage from a wound.
• Swelling or redness in one leg.
• Trouble breathing or a cough that will not go away.

Questions to ask before surgery day

• What time should I arrive, and exactly when should I stop eating and drinking?
• Which of my medicines should I take that morning, and which should I stop beforehand?
• Will I have general or spinal anesthesia, and is there a choice?
• I have had nausea after anesthesia before (or I get motion sickness): what will you do to prevent it?
• How long is the operation likely to take, and how will my family get updates?
• Do you expect me to go home the same day or stay overnight? What has to happen before I can leave?
• What pain and anti-sickness medicines will I take home?
• Who do I call at night or at the weekend if I have a problem?

Sources

1. MedlinePlus (U.S. National Library of Medicine). The day of your surgery – adult. medlineplus.gov
2. American Society of Anesthesiologists. Preparing for surgery: adult checklist. Made for This Moment. madeforthismoment.asahq.org
3. Joshi GP, Abdelmalak BB, Weigel WA, et al. 2023 American Society of Anesthesiologists practice guidelines for preoperative fasting: carbohydrate-containing clear liquids with or without protein, chewing gum, and pediatric fasting duration. Anesthesiology. 2023;138(2):132–151. pubmed.ncbi.nlm.nih.gov
4. American Society of Anesthesiologists. New multi-society clinical practice guidance released (perioperative use of GLP-1 receptor agonists). News release, October 2024. asahq.org
5. American Society of Anesthesiologists. Types of anesthesia. Made for This Moment. madeforthismoment.asahq.org
6. NHS. Hysterectomy: how it’s performed. nhs.uk
7. Garry R, Fountain J, Mason S, et al. The eVALuate study: two parallel randomised trials, one comparing laparoscopic with abdominal hysterectomy, the other comparing laparoscopic with vaginal hysterectomy. BMJ. 2004;328(7432):129. pubmed.ncbi.nlm.nih.gov
8. Perron-Burdick M, Yamamoto M, Zaritsky E. Same-day discharge after laparoscopic hysterectomy. Obstetrics & Gynecology. 2011;117(5):1136–1141. pubmed.ncbi.nlm.nih.gov
9. Aarts JW, Nieboer TE, Johnson N, et al. Surgical approach to hysterectomy for benign gynaecological disease. Cochrane Database of Systematic Reviews. 2015;(8):CD003677. pubmed.ncbi.nlm.nih.gov
10. American Society of Anesthesiologists. Anesthesia recovery. Made for This Moment. madeforthismoment.asahq.org
11. NHS. Hysterectomy: recovery. nhs.uk
12. NHS. General anaesthetic. nhs.uk
13. Apfel CC, Läärä E, Koivuranta M, Greim CA, Roewer N. A simplified risk score for predicting postoperative nausea and vomiting: conclusions from cross-validations between two centers. Anesthesiology. 1999;91(3):693–700. pubmed.ncbi.nlm.nih.gov
14. Gan TJ, Belani KG, Bergese S, et al. Fourth consensus guidelines for the management of postoperative nausea and vomiting. Anesthesia & Analgesia. 2020;131(2):411–448. pubmed.ncbi.nlm.nih.gov
15. Royal College of Obstetricians and Gynaecologists. Laparoscopic hysterectomy: recovering well. rcog.org.uk
16. Apfel CC, Philip BK, Cakmakkaya OS, et al. Who is at risk for postdischarge nausea and vomiting after ambulatory surgery? Anesthesiology. 2012;117(3):475–486. pubmed.ncbi.nlm.nih.gov
17. American College of Obstetricians and Gynecologists. Committee Opinion No. 750: Perioperative pathways: enhanced recovery after surgery. Obstetrics & Gynecology. 2018;132(3):e120–e130. pubmed.ncbi.nlm.nih.gov
18. Nelson G, Bakkum-Gamez J, Kalogera E, et al. Guidelines for perioperative care in gynecologic/oncology: Enhanced Recovery After Surgery (ERAS) Society recommendations – 2019 update. International Journal of Gynecological Cancer. 2019;29(4):651–668. pubmed.ncbi.nlm.nih.gov
19. MedlinePlus (U.S. National Library of Medicine). Hysterectomy. medlineplus.gov
20. Royal College of Obstetricians and Gynaecologists. Abdominal hysterectomy: recovering well. rcog.org.uk
21. Dedden SJ, Maas JWM, Smeets NAC, et al. Same-day discharge after laparoscopic hysterectomy for benign/premalignant disease: a multicentre randomised controlled trial. BJOG. 2024;131:1762–1770. pubmed.ncbi.nlm.nih.gov
22. MedlinePlus (U.S. National Library of Medicine). Hysterectomy – laparoscopic – discharge. medlineplus.gov

This article is for general information and is not a substitute for medical advice. Always follow the fasting, medicine and discharge instructions from your own surgeon and anesthesia team, and contact them, or call 911, if you are worried about any symptom after surgery.