Nothing to Eat or Drink after Midnight

Sometimes it seems like pre-surgery rules are designed to make you more miserable.  This one has a pretty good explanation.

  • When anesthesia or sedation is induced, for a few seconds you might lose control of what’s in your stomach. There’s a small chance that stomach contents will reflux up into your mouth and that you could inhale them.  That’s a very bad thing and could first cancel your surgery, and then possibly necessitate antibiotics or hospital admission depending on how bad the aspiration was and how sick you are in general.

  • There are three things in your stomach that would be bad to inhale. Bile, acid, and particulate matter (solid food).  The bile and the acid will always be there but their volume is less when you haven’t eaten.  The particulate matter you can control so don’t eat anything solid (milk counts as a solid, even if it’s just in your coffee) for at least 8 hours before your scheduled surgery time.

  • Clear liquids, however, are absorbed quickly once in your stomach and probably wouldn’t make an aspiration worse. Usually it’s okay for patients to have clear liquids until 2 hours before their procedure (meds with a sip of water etc.  Orange juice is NOT a clear liquid.).  Give yourself at least an hour buffer to be safe.

  • We (those of us giving out pre-op instructions) tell everyone not to eat or drink after midnight. It’s easier to tell everyone the same time than to need each patient to calculate 8 hours before their procedure and maybe get it wrong.  Also, sometimes procedures get moved up in the day.  Midnight is 8 hours before usual OR day start time (in room 7:30, start 8:00-ish) so it’s a good blanket time to tell everyone.

  • What’s the bottom line? Your stomach should be as empty as possible when you go to sleep.  If your surgery is scheduled late in the day, have a snack 8-9 hours pre-op and sip on water through the day.  That way you’re less likely to be starving and dehydrated when you go in but you won’t screw up your surgery timing either.

Leave a Reply

Scroll to top