"Intoxicated" beauty protection! The issue of fasting before surgery is not an exaggeration!

The most common question anesthesiologists are asked in their daily work is: "Why can't I eat? What should I do if I'm hungry? Does it have any effect on my body?"

Some people think that eating something before surgery will give them the energy to get through the surgery and anesthesia. Experts from the Xiangdong Hospital affiliated to Hunan Normal University said that this is actually a wrong understanding. Eating or drinking will only lead to the cancellation or delay of the surgery. If you conceal eating, the price you pay may be your life!

1. Why do we need to fast and abstain from drinking?

1. When a person is under anesthesia, the body's protective choking and swallowing reflexes are weakened or disappear, and the gastric contents are very easy to reflux, causing aspiration, suffocation, or even death, or aspiration pneumonia.

2. Most gastrointestinal surgeries require the gastrointestinal tract to remain empty to avoid intraoperative contamination of the surgical field and postoperative gastrointestinal distension or anastomotic rupture.

3. Some patients who undergo non-gastrointestinal surgery may experience abdominal distension and vomiting after surgery due to stimulation of the peritoneum or internal organs by the surgical operation, or due to the adverse effects of certain anesthetics on the digestive system.

4. Some surgeries use local anesthesia, but if the patient cannot cooperate or other situations occur, the anesthesia method needs to be changed during the operation, and the risk of reflux aspiration is higher.

2. Fasting and abstinence time

According to the 2021 "Chinese Clinical Practice Guidelines for Accelerated Recovery After Surgery", fasting and drinking before surgery generally follow the "2-4-6-8" principle.

2: You can drink a small amount of clear drinks 2 hours before anesthesia, including water, nutritious high-carbohydrate drinks, carbonated drinks, clear tea, black coffee (without milk) and various residue-free fruit juices, but they cannot contain alcohol and the total amount should be ≤400ml.

4: Newborns and infants who are breastfed need to fast for 4 hours before anesthesia. If they are fed with milk or formula milk, they need to fast for 6 hours.

6: Starchy foods, easily digestible carbohydrates that do not contain fat and meat, such as bread, toast, steamed buns, noodles, rice, porridge, etc., should be fasted for at least 6 hours.

8: Fast for at least 8 hours from fat, solid meat foods, fried foods, high-protein foods, and foods that are difficult to digest, such as pork, chicken, beef, eggs, etc.

3. Notes on fasting and drinking

The prescribed fasting time is only applicable to patients or children without gastrointestinal motility disorders.

Infants and newborns can be given intravenous sugar-containing fluids in the ward after fasting for 2 hours to prevent hypoglycemia and dehydration. Emergency surgery should also be supplemented with fluids during fasting. Surgery for diabetic patients should be arranged as the first operation as much as possible. If this is not possible, fluids can be given intravenously in the ward and blood sugar should be monitored.

Patients who need to take oral medications before surgery are allowed to crush the tablets and swallow them 1 to 2 hours before surgery and drink 0.25 to 0.5 ml/kg of water. However, it should be noted that sustained-release preparations are strictly prohibited from being crushed and taken orally.

Patients undergoing emergency surgery should be anesthetized as if they were on a full stomach.

It is necessary to extend the fasting time in the following situations: patients with severe trauma, where the time from eating to injury is less than 6 hours; patients with gastrointestinal obstruction; obese patients; patients with difficult airway; patients with central nervous system diseases such as craniocerebral injury, intracranial hypertension, and coma.

Patients undergoing elective surgery for the gastrointestinal tract or other conditions who have special or higher requirements for preoperative fasting should follow the requirements of the specialist.

4. Tips

Before surgery, the patient needs to tell the doctor their medical history, medication history, allergy history, smoking history, motion sickness history, and even lifestyle habits in as much detail as possible to better ensure safety.

Hunan Medical Chat Special Author: Xie Minna, Department of Anesthesiology (Operating Room), Xiangdong Hospital Affiliated to Hunan Normal University

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(Edited by YT)