If you’ve ever had surgery or known someone who has had surgery, your probably familiar with the idea that you are not supposed to eat or drink anything after midnight, the night before your surgery.

As a nurse, I’ve taken care of countless patients preparing for surgery, and many of them have had questions about the reasons behind this practice. Why do we do this? What does this have to do with my knee surgery? Can’t I have just a little bit of water, my surgery isn’t until lunch time?

First and foremost, the main reason we practice the “stop eating and drinking” is that you don’t want to your stomach contents to go into your lungs while you are having your surgery. This can cause all kinds of problems.

When you are under anesthesia, you lose control of your muscles and ability to swallow and protect your airway. Respiratory reflexes such as the gag reflex, which normally prevents vomited food or gastric juices from entering the lungs, is suppressed. Food, stomach juices, or saliva can enter the trachea, the tube that leads to the lungs.

Stomach contents moving into your lungs can cause mild lung inflammation to very serious, potentially life-threatening cases of pneumonia. Food and drink do not belong in your lungs, and this can easily happen if you have contents in your stomach while you are undergoing surgery.

This is the #1 reason why we don’t want you eating or drinking before surgery. We realize that you are hungry and thirsty, but the risks associated with aspiration are very real and we must do everything we can to protect your safety.

Have you ever swallowed food or drink and it went down the wrong pipe? We’ve all done this, but we are usually able to initiate our coughing and gag reflexes to help clear the material. In this situation your cough is your best friend, but when you are having surgery, you are lights out and not able to cough, gag, or clear your airway.

Just think about the last time that food went down the wrong pipe and your body went into “we better fix this right now” mode. When you are under anesthesia, you have no ability to fix it on your own.

Now there is some research out there that is challenging the notion of not eating or drinking after midnight. In fact, many anesthesiologists believe it is safe to have clear liquids up to a few hours before surgery.

Here at WVMC, we continue to examine the latest evidence and scientific community recommendations. Our #1 goal is always to protect your safety, and keeping your stomach empty before surgery is one of the most effective ways we can accomplish that goal.

Cheers.