The secret of surgical safety: fasting and no drinking, do you really understand its importance?

Surgery is a widely used method of treating diseases in clinical practice. Before a patient undergoes a surgical operation, doctors and nurses usually inform the patient that they need to fast and not drink. At this time, some patients may have some questions in their minds: Why do they need to fast and not drink before surgery? Will drinking less water or eating a little less affect the operation?

In the General Surgery Ward of the Minimally Invasive Surgery Center of the Second People's Hospital of Hunan Province (Provincial Brain Hospital) , patients also have such questions. Doctors and nurses will give detailed explanations and guidance on these questions. Below, we will introduce the reasons and importance of fasting before surgery, as well as the differences in fasting for different types of surgeries and different surgical populations.

1. Why should patients fast and not drink before surgery?

The first important reason is to prevent vomiting and aspiration . During surgery, the human body's normal physiological reflexes such as swallowing and coughing will be suppressed under the effect of anesthetics. If the patient eats or drinks before surgery, the stomach is filled with food and liquid. During surgery, especially when the patient is in the supine position, the patient's stomach is squeezed, or because of the stimulation of the gastrointestinal tract by anesthetics, vomiting is easily induced.

Once vomiting occurs, the gastric contents may flow back into the throat. The mixture may be accidentally inhaled into the trachea and lungs, blocking the respiratory tract and causing aspiration pneumonia. In severe cases, it may lead to suffocation and respiratory failure of the patient, seriously threatening the patient's life.

Therefore, patients must follow the doctor's orders and abstain from food and drink before surgery. There is no need to worry about the impact of "hunger" on the body. Doctors and nurses will ensure the patient's nutrition and water and electrolyte balance through appropriate means before, during and after surgery.

The second important reason is to ensure the smooth progress of the operation . If there is food and liquid residue in the patient's stomach, during the operation, the stomach will secrete a large amount of gastric acid and digestive juice due to the stimulation of food, which will not only increase the burden on the gastrointestinal tract, but also cause the gastrointestinal tract to swell, affect the surgical field of view, and interfere with the doctor's surgical operation.

In addition, because gastrointestinal motility and digestion affect operations, it is very easy to cause complications such as gastrointestinal perforation and bleeding during surgery, which not only prolongs the operation time and increases the risk of surgery, but also brings great difficulties to the patient's postoperative recovery.

2. What are the requirements for fasting and drinking during different surgeries?

Different types of surgery and different methods of anesthesia have different requirements for fasting and abstaining from food and drink.

Generally speaking, if it is an elective general anesthesia surgery, fasting should start 6 to 8 hours before the surgery, and drinking water should be stopped 2 to 4 hours before the surgery . However, in recent years, under the concept of accelerated recovery after surgery, the fasting and abstinence time can be appropriately adjusted or shortened based on the strict evaluation of doctors and nurses. For local anesthesia surgery, if the surgical site is not near the gastrointestinal tract, the fasting and abstinence time can be appropriately shortened, but it is also necessary to fast and abstain from water 2 to 4 hours before the surgery to ensure the safety of the operation.

In addition, special patients such as diabetics, elderly patients, children, and emergency surgery, need to be given fasting and drinking abstinence guidance by professional doctors based on their specific conditions before undergoing surgery. Patients also need to maintain a good attitude and not be overly nervous or anxious due to fasting and drinking abstinence. If they experience symptoms such as thirst, hunger, palpitations, cold sweats, etc. during the fasting and drinking period, they should promptly tell the doctor or nurse for treatment.

Hunan Medical Chat Special Author: Liu Li, General Surgery, Minimally Invasive Surgery Center, Hunan Second People's Hospital (Provincial Brain Hospital)

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(Edited by Wx)