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Preoperative Fasting

Prepared by: Cathy Bachman MD

Does my child have to fast before surgery?


Why is fasting necessary before surgery?

When patients receive anesthesia for surgery, they become very relaxed and sleepy. When patients are this sleepy, the muscles of the stomach and throat which normally stop food from coming up into the throat, and then going down into the windpipe or trachea, and then into the lungs, are also relaxed. When patients get food or liquid into their lungs from the stomach, this can cause pneumonia or even death. To minimize the risk of this happening, patients are asked not to eat or drink for a certain length of time before surgery. If the stomach is therefore empty, the risk of anything coming up from the stomach and getting into the lungs is extremely low. Anesthesia is therefore much safer.

How long does my child have to fast before surgery?

Food and milk empty from the stomach much slower than clear liquids. To make sure the stomach is as empty as possible by the time anesthesia is started, patients must be fasting longer from food or milk than from clear liquids. You should always check with your doctor to see what they recommend Frequently used recommended fasting times for different types of food and liquids are as follows:
Type of food or liquid Fasting time before surgery
Fatty or fried food 8 hours
Light meal, milk 6 hours
Breast milk (infants) 4 hours
Clear liquids 2 hours

What type of liquids are CLEAR LIQUIDS?

Clear liquids are any type of liquids that, when poured into a clear glass, would allow you to see through them. Some examples are water, electrolyte solutions, apple juice, and carbonated soft drinks or pop. Any liquid that you cannot see through, such as orange juice or milk, empties from the stomach slower, and should be treated as a "light meal" in terms of fasting.

Should my child take his or her medications before surgery?

This is a question you should ask your anesthesiologist ahead of time, because some medications should be continued right up to immediately before surgery, and others may be stopped the day of surgery. In general, medications taken with a sip of water before surgery do not make the stomach "full", and therefore do not increase the risk of anesthesia.

What if the surgery is an emergency?

Emergency surgery cannot be planned ahead of time. When the decision is made that surgery is necessary, the patient will not be allowed to eat or drink before surgery. An intravenous may be started, which will allow the patient to receive fluid through a vein. If the patient's stomach is not considered to be empty but surgery cannot wait, the anesthesiologist will take special precautions to reduce the risk of any stomach contents getting into the patient's lungs. These precautions are very effective almost all patients.

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