I, an anesthesiologist, have been practicing medicine for over 20 years. There is a question that has been bothering me. Despite years of effort, nothing seems to have fundamentally changed.
This question is about fasting water before surgery.
Some people will say: What’s wrong with fasting water before surgery? Isn’t it that you are not allowed to eat or drink before surgery?
Yes, that’s the problem.
If you don’t think there is any problem, let me remind you: the day before the operation, did the doctor or nurse ask you not to eat or drink after ten o’clock in the evening?
Are you here, do many friends suddenly recall this episode?
The problem is at this point in time. The time of not eating or drinking is fixed, but the time of surgery is not necessarily. If the first operation in the morning is fine, what if it is in the afternoon? Lift the bar a little more, how about tonight? What about midnight?
Some people said: Don’t make trouble, how could surgery be done in the middle of the night?
Actually, it is not rare to have surgery in the middle of the night, and it is an elective surgery.
In the first ten years of my work, at least one-third of the time I was unable to go home on time at night. At the latest, it really worked until midnight.
Remember that time, we have been working at a high intensity, and we didn’t feel tired at all. But when I saw the sleepy stupefied patient being picked up from the ward by the nurse, my heart was touched! What touched me was that it is not easy to perform surgery as a patient. Waiting from morning to night, and then to midnight. Until I get tired and sleepy. Just fell asleep, but was called up again.
As I know a little about Chinese medicine, I know very well that this kind of time is not suitable for surgery. In the middle of the night, the liver meridian of our body is being cultivated. After a hard day’s work, the body needs to recover at this moment, which is why the elderly do not let them stay up late. From the point of view of anesthesia, it is indeed found that patients who perform surgery in the middle of the night are unwilling to wake up. Yes, who wants to wake up in the middle of the night!
However, not only the fear of surgery, the sleepiness of the biological clock, but also the discomfort of starvation are added to the patient at this time.
The fear of surgery, we can comfort; the sleepiness of the biological clock, we can’t solve it. We also want to do it quickly, but the surgery arranges a lot of operations every day, and there is always a sequence; the only thing is hunger, I think it is easy to solve.
Some people say: If you are hungry, you will be hungry. After going to the hospital for surgery, can it be as comfortable as lying down at home?
This is not a matter of comfort or discomfort, it is related to the patient’s hospital recovery in the long run; it is directly related to the quality of anesthesia in the near future. Relevant studies have shown that starvation not only directly affects nutrient supply, but also affects the early recovery of postoperative intestinal function. Most of the patients in starvation state have varying degrees of volume depletion and even electrolyte imbalance, which may become factors that affect the safety of the perioperative period.
In the past, I also tried to get the medical staff in surgery to update their concepts, but I didn’t know why. But I really want to say something: surgical medical friends, the concept of fasting water before surgery should be updated!
What you have been asking your patients to do is more than half a century ago. Even, it can be traced back to the founding of the People’s Republic of China. Limited data show that the 12-hour fasting and 8-hour water fasting rule was carried over from that time. And scientific fasting water should be individual. At the very least, it should be done in accordance with the fasting water program of 8 solids, 6 easy-to-digest, and 4 clear drinks to accelerate postoperative recovery that everyone is now strongly advocating.
If you encounter special patients, you can’t be the same. For example, when a diabetic patient undergoes surgery, excessive hunger is very unfavorable for the patient.
Every year, more than 60 million operations are performed in domestic operating rooms. How many of them were anesthetized in starvation? Thinking about it, I feel that there are still many aspects that we haven’t done well~
[Warm reminder] Please pay attention, there are a lot of professional medical science, to reveal the secrets of surgical anesthesia for you~