Shortly Before General Anesthesia, Do Not Eat Food and Drink Water in Secret From Your Doctor!

General Anesthesia With a Full Stomach May Cause Fatal Lung Damage!

Today I had one of the most difficult days in my professional life and I would like to share it with you. Even if the operation is planned under a simple operation or a short-term general anesthesia; There are various guides,i and rules that include what should be done before general anesthesia. For example, the pre-operative fasting and thirst period is very important for the prevention of aspiration, which is vital.

Please do not hide your hunger and thirst times from your doctor!

Before a simple septoplasty operation, I visited my patient in his room and inquired whether he had taken any blood thinners and the duration of hunger and thirst 1 week ago. My patient told me that he had been hungry and thirsty for more than 8 hours, and it was written in the patient's file that he was hungry and thirsty by the nurse ladies. When the anesthesia team started to give the first drugs for general anesthesia, gastric juice, various foods (corn, rice, pizza pieces) gushed out of the patient's mouth like a waterfall, and since it was an emergency, the drugs given for anesthesia were terminated and the stomach contents were aspirated. The patient was ventilated and awakened. It was very frightening that the right lung sounds were less and their saturation decreased during awakening. Chest diseases specialist consultation and chest X-ray were requested from the patient. If any feature was detected in the chest X-ray of the patient, oral antibiotics and mucolytic drugs were given to the patient and discharge was planned. It was planned to re-evaluate the patient by a pulmonologist a few days later in terms of late-stage lung injury due to aspiration. Maybe it was a very dangerous situation that was easily circumvented. When I spoke again after the patient woke up, I learned that he could not stand and ate only 1.5 hours ago. Indeed, this is a situation that may cause serious permanent health problems, maybe even intensive care hospitalization due to lung damage.

This situation made me a little tired, the tired expression on my face 😌

Before General Anesthesia, you should start to stay hungry and dehydrated at least 6-8 hours before

During general anesthesia, all body muscles and muscles of the gastrointestinal tract stop working. When there is food or drink in the stomach, when anesthetic drugs are started to be given to a patient, the stomach contents can easily move upwards while lying on the operating table in a horizontal position, even the small amount of acidic content reaching the lungs may be sufficient for lung damage. In the event that such acidic and food-containing contents move towards the airways in the lungs, the patient must be awakened immediately and the stomach must be aspirated. If air is started to be pumped into the lungs by placing an intubation tube without noticing the aspiration in the patient, all the acidic drink can be pushed towards the more extreme airways and the lung damage is deepened. In this case, a decrease in the patient's oxygen saturation and a decrease in lung sounds may occur.

Eating and Drinking Water Few Hours Before General Anesthesia Can Cause Fatal Problems!

Please pay attention to the fasting and thirst times you are told before general anesthesia. Pay attention to the warnings you have been told by your doctor and if you have eaten or drank any liquid in less than 6 hours, do not hesitate to talk to your doctor about delaying your surgery.

My patient is very well and there is no problem, we are happy!

The problem I shared with you here was for the attention of all our patients who were scheduled for general anesthesia. Pay attention to the recommendations of your doctor before the operation, do not stress, the time you are hungry and thirsty is for your well-being and to reduce the known anesthesia risks.

You can take a look at the scientific studies published on this subject with detailed information >>

• Pulmonary Aspiration During Induction of General Anesthesia | Anesthesia Progress (allenpress.com)
• Mendelson Syndrome - StatPearls - NCBI Bookshelf (nih.gov)
• An international multidisciplinary consensus statement on fasting before procedural sedation in adults and children - Green - 2020 - Anaesthesia - Wiley Online Library
• Critical aspiration pneumonia during induction of anesthesia in elective abdominal surgery: a case report - PubMed (nih.gov)

Murat Enoz, MD, Otorhinolaryngology, Head and Neck Surgeon

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