If you have undergone any surgical procedure, you are likely familiar with the instruction from the treating physicians to fast before the procedure. You may not be aware of the reasons behind it, but the main purpose is that fasting helps the body prepare for the operation and reduces the risk of complications during it.
Fasting before surgery is crucial to avoid a potentially serious complication known as pulmonary aspiration or bronchoaspiration. When our level of consciousness decreases, we lose the ability to protect the airway and lungs, risking the passage of stomach contents into the airway. Under normal conditions, humans have protective mechanisms in the throat that prevent this from happening, but when unconscious, this protective ability is lost.
The contents in our stomach are acidic, and if they reach the lungs, the patient may require intubation, mechanical ventilation, or even face the risk of death as it is highly damaging. The way to reduce this risk is by ensuring that there is no content in the stomach.
After being evaluated by the specialist and anesthesiologist, the patient will be given some preoperative instructions. The fasting periods recommended for anesthesia procedures are standardized and vary depending on the type of food. For pediatric patients receiving breast milk, a 6-hour fasting period is sufficient; for cow’s milk or commercial formulas in pediatric patients, a 6-hour fasting period is recommended, and for solid meals, an 8-hour fasting period is necessary.
Regarding medications taken chronically, they should be taken as instructed by the treating physician, who may even allow their intake on the same day of the surgery. However, there are certain medications such as anticoagulants, antiplatelet drugs, certain medications for treating diabetes or hypertension, and others that need to be discontinued before an operation.
What about emergency surgical procedures?
In urgent procedures where patients have not been able to comply with the fasting period, the relationship between the risk of anesthetizing a patient without adhering to the fasting period and the benefit obtained by performing the procedure urgently must be evaluated.
Proper communication between the medical teams is crucial because the decision to perform emergency surgery involves assuming the risk of aspiration. In such situations, anesthesiologists can administer drugs that help expedite gastric emptying and take measures to reduce the risk in these patients.
Adhering to the fasting requirements before a surgical intervention ensures stomach emptying to reduce gastric acidity, achieving the primary objective of avoiding vomiting and aspiration during the procedure.
It is important to undergo preoperative examinations and have a consultation with the treating physician, as well as properly follow the guidelines established by the specialist before the intervention. This guarantees a surgical procedure with lower risk, a prompt recovery, and optimal intervention outcomes.