Aspiration can happen with saliva or the food and fluid you drink. Under general anesthesia your ability to react is gone because your muscles are paralyzed and you are unconscious, so you cannot "cough it up.
While aspiration is most common during general anesthesia, it can also happen when a patient is sedated or too sick to protect their airway. If your surgery will be in part of your gastrointestinal system, having food in your system could complicate the surgery and lead to infection.
Eating or drinking prior to your procedure could cause the surgery to be canceled. In some cases, bowel preparation is done, a process that completely empties your digestive tract to prepare for surgery. To eat or drink after your bowel preparation could undo all of your efforts to empty your digestive tract.
Postoperative nausea and vomiting PONV is one of the most common complications of surgery and is far easier to prevent than to treat and control after it begins. While there are medications available to treat nausea and vomiting, the easiest way to prevent it is to have an empty stomach when anesthesia is provided.
Additionally, if you have food or fluid in your stomach during your surgery, you could vomit while under anesthesia. The combination of anesthesia, which paralyzes the body, and intubation makes it possible for you to inhale the vomit into your lungs. Asleep and paralyzed, your ability to cough, or even to spit vomit out of your mouth, is taken away and the risk of aspiration is high.
This aspirated food or fluid can quickly lead to aspiration pneumonia, a lung infection caused by inhaling foreign material. The best way to prevent aspiration from happening is to make sure your stomach is empty before surgery.
Protein is an essential part of the healing that takes place after surgery. Hydrate, preferably with water, until your urine is clear and mostly colorless. You may be pleasantly surprised by how you feel when you drink an adequate or ample amount of water—those little aches and pains that you believe to be normal may go away entirely, and you may feel more energetic. Eating and drinking well prior to your period of fasting will help you tolerate the process better, especially if you drink enough fluids to prevent significant thirst during your fast.
You may be tempted to have a huge meal before you start your eight- to hour fast. Do not give in to the temptation, as it can completely defeat the purpose of fasting.
Instead, have a light meal such as soup and salad for your final meal before surgery. A heavier meal takes longer to digest and negates the effect of abstaining from food and drink prior to surgery. If your surgeon has said you should take your regular medications on the morning of your surgery, plan to do so with the smallest sip of water possible.
Do not take your medication if the surgeon has not instructed you to do so. If you are unsure, call the doctor's office or take them with you to the surgical center.
We use this information to improve our site. Let us know if this is OK. You can read more about our cookies before you choose. Change my preferences I'm OK with analytics cookies. Theatre staff at Nottingham University Hospitals NHS Trust have exploded the myth of long-standing practices around fasting patients before their operations. The unwritten rules around a perceived need more severe fasting over longer periods are widely accepted and have remained unchallenged for decades.
Myth: You can breathe food from the stomach into the lungs while under anaesthetic. Busted: The risk of choking is minimal. Myth: You should rest following an operation After being nil-by-mouth and going through an operation, a patient can go through dramatic weight-loss. Busted: With Enhanced Recovery , the patient is encouraged to be up on their feet after surgery. By Topdoctors. Te llamaremos lo antes posible Leave us your contact details and we will call you free of charge.
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Set Cookies. RCN guidelines state that as long as there are no contraindications, patients can be offered and encouraged to drink fluids post-operatively. They say it may be better for children to try breast milk or clear fluids first. This does not apply to patients who have had gastrointestinal or major abdominal surgery.
Key aspects are managing fluid balance and fasting times, and ensuring patients do not become malnourished or dehydrated. Patients are given a clear, carbohydrate-rich drink before midnight and a second drink hours before surgery to reduce their discomfort from fasting and pre-operative thirst and hunger Brady et al, The evidence suggests that carbohydrate drinks pre-operatively result in a shorter stay in hospital due to a quicker return of bowel function, a reduced loss of body mass and a decrease in post-operative nausea and vomiting Jones et al, Fluids and diet are often reintroduced on the day of surgery to promote gut motility and reduce the risk of the patient developing an ileus when peristalsis stops and the bowel ceases to function Varadhan et al, Nurses need to know when patients exceed their fasting time and discuss introducing intravenous fluids with doctors.
BAPEN offers recommendations on pre-, intra- and post-operative fluid management in adult surgical patients. Mechanical bowel preparation is avoided where possible but, if it is necessary, it is common for an electrolyte imbalance and dehydration to occur; this should be corrected with IV fluid and closely monitored BAPEN, ; National Confidential Enquiry into Patient Outcome and Death, Nursing care should include maintenance of an accurate fluid balance chart; cannula care should include the use of a phlebitis scale to prompt action.
Patients receiving additional fluid or nutritional support should have their fluid balance recorded on a fluid balance chart so it can be assessed. This should include:. Fasting can cause oral discomfort Box 2 and be an infection risk. Oral care is sometimes neglected by nurses and not considered a priority RCN, ; Bisset and Preshaw, Some patients will have experienced oral problems before surgery due to treatment or an existing problem, for example:.
Post-operatively, patients may remain NBM for several hours or longer and be prone to xerostomia due to dehydration, oxygen therapy and side-effects of the anaesthetic.
They will need frequent oral care Bisset and Preshaw, Mouthwash should be available for patients; they may prefer to use their own but those that contain alcohol can have a drying effect on the mouth. Chlorhexidine mouthwashes can reduce the level of plaque and bacteria but should not be used more than twice a day because of their alcohol content. Dingwall suggests using 0.
Patients who wear dentures may prefer to keep them in for as long as possible, sometimes until induction of the anaesthesia; however, a dry mouth can make wearing them uncomfortable. Nutrition is important in preventing pressure ulcers NICE, and forms part of the risk assessment. Nurses must consider other factors that could increase the risk, such as:.
Educational and clinical institutions must work together to educate all healthcare workers so patients have the best possible care when they are NBM. Surgeons, nurses, theatre staff, students and housekeeping staff need to follow the most recent guidelines. Patients must be educated and kept informed about their NBM status. The RCN guidelines inform practice; local policies should reflect them.
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