why do you have to fast before surgery

How Long Is Long Enough? If you've ever undergone surgery, you probably received the traditional pre-op order: Don't eat or drink anything after midnight prior to the day of surgery. Some experts agree that the length of the recommended fast is needlessly long. Fasting guidelines have been relaxed in recent years, but it's not uncommon for patients to be given the traditional after-midnight order. While it's always best to
follow your doctor's advice, it's perfectly reasonable to ask about relaxing the fasting requirements especially if you're scheduled for an afternoon procedure. In that case, you might be asked to go without food for more than 12 hours! Doctors and anesthesiologists are often willing to accommodate your wishes. The after-midnight order has been the norm for decades. It's a precautionary measure to prevent pulmonary aspiration, which occurs when stomach contents enter the lungs, potentially blocking airflow and putting patients at risk for serious infections like pneumonia. However, modern anesthesia techniques make pulmonary aspiration much less likely. And when it does happen, it almost never results in long-term complications or death. What's more, research has demonstrated that the stomach empties much faster than previously believed, and a long fasting period probably won't reduce aspiration any better than a short fast.


A long fast may add to discomfort during recovery. Fasting can lead to headaches, nausea, dizziness and dehydration. Dehydration can be serious and makes it difficult for nurses to draw blood for necessary tests. In its preoperative fasting guidelines, the American Society of Anesthesiologists says it's safe for healthy people of all ages Clear liquids, including water, clear tea, black coffee, carbonated beverages and fruit juice without pulp, up to two hours before surgery Very light meals, like toast and tea with milk, up to six hours before surgery Heavy meals, including fried or fatty foods and meat, up to eight hours before surgery Despite these guidelines, don't be surprised if you schedule an elective procedure and are given after-midnight instructions. Many surgeons and hospitals continue to recommend the traditional after-midnight order on the assumption that it's easier to give everyone the same instructions. Therefore, patients don't need to count down the hours before surgery when making decisions about what to eat or drink, and health care professionals don't need to sort out which patients should have different fasting times. Some patients do need to follow the after-midnight rule. These include people who have gastroesophageal reflux disease (GERD) and people with gastric paresis (paralysis of the stomach that can occur in people who have diabetes).


These individuals have an increased risk of vomiting and aspiration during surgery and should be instructed to fast for a longer period as should people undergoing gastric or intestinal surgeries. A blanket after-midnight order protects people who might have undiagnosed GERD or diabetes. Source: Prepared by the Editors of The Johns Hopkins Medical Letter: Health After 50 Every operation is different, and whether or not you are allowed to eat or drink beforehand, and what you can have, will depend on the type of operation being carried out. Before you have your operation, the health professionals treating you will tell you whether you can eat or drink and, if eating and drinking is permitted, what foods and liquids you can have. Before having an operation, it's likely that you'll be given either a local or a general anaesthetic. A local anaesthetic numbs the area being treated, so that you don't feel any pain. A general anaesthetic makes you unconscious so that you can't feel anything, and you aren't aware of what's going on during the procedure. Usually, before having a, you won't be allowed anything to eat or drink. This is because when you're under anaesthetic, your body's reflexes are temporarily stopped. If your stomach has food and drink in it, there's a risk of vomiting, or regurgitation (bringing up food into your throat).


If this happens, the regurgitated food could spill into your lungs and affect your breathing, as well as causing damage to your lungs. The amount of time that you have to fast for (go without food or drink) before you have your operation will depend on the procedure that you are having. However, it is usually six to eight hours for food, and two hours for fluids. The use of chewing gum, including nicotine gum, should be avoided during this fasting period. You may be told to avoid certain types of fluids, such as milk, or white tea and coffee, as they have proteins and fats in them which could damage your lungs. Clear fluids, such as water, black tea or coffee, or processed fruit juices, are usually recommended. Infants can be given breastmilk up to four hours before an operation. After that time only clear fluids should be given. If you have a medical condition, such as, that means you need to eat and drink regularly, you should tell one of the healthcare professionals treating you prior to having an operation. You should also let them know if you are taking any medication. If you are having a, you should be allowed to eat and drink as normal before you have the procedure. An exception to this is maybe if you are having a procedure that involves your digestive system or bladder. Further information:

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