What can I eat and drink the night before and day of my procedure/surgery?
If you are getting any anesthesia, you need to follow these instructions.
8 hours before
Unless told differently by your doctor, do not eat food for 8 hours before your procedure. Also, stop food or formula given through a feeding tube.
6 hours before
Do not drink non-clear fluids for 6 hours before your procedure. Non-clear fluids are:
- Milk
- Hot chocolate
- Coffee or tea with milk, cream, or nondairy creamer
- Orange juice (with or without pulp) and other fruit juices with pulp
- Smoothies
- Tube feeds, such as Promote®, Impact®, and Nepro®
2 hours before
- You may drink clear fluids until 2 hours before your procedure if your doctor approves. Clear liquids are:
- Apple or white grape juice (not orange juice)
- Black coffee without milk, cream, or creamer
- Clear tea without milk, cream, or creamer
- Carbonated drinks, such as Coke® or 7-Up®
- Clear, fat-free broth
- Infant electrolyte drinks, such as Pedialyte®
- Non-turbid clear protein drinks, such as Ensure Clear®, Premier Protein®, and Fizzique®
- Sports drinks, such a Gatorade®
- Water
- Remember:
- Clear fluids cannot be hazy or cloudy. They cannot have pulp or fats.
- No milk, creamer, or lemon added to any drinks.
- No alcohol.
- Do not swallow gum, mints, or candy.
2 hours or less before your procedure
- Do not eat or drink anything if possible. If you must take prescribed medicines, take them with 1 ounce of water.
Your stomach must be empty for anesthesia. We do not want food from your stomach to get into your lungs. Your procedure will be delayed or cancelled if you do not or cannot follow these instructions.
Why can’t I eat or drink before my procedure?
Our protective reflexes slow down when we are given anesthesia. One protective reflex is to keep stomach contents from going into our airway. Aspiration can happen when stomach contents enter our airway. This is less likely to happen when your stomach is empty. Fasting (not eating or drinking) keeps your stomach empty.
Why is aspiration bad?
Solid or semi-solid stomach contents may not let your lungs get air. Liquid stomach contents that are acidic may burn your lungs and stop you from getting air. Both types of aspiration may cause brain damage or death.
Aspiration can be treated. Most people survive, but treatment in an intensive care unit (ICU) is often needed. Aspiration may lengthen your hospital stay by days to weeks.
Can I have gum or hard candy while waiting for my procedure?
Adults (18 years and older) can chew gum or suck hard candy. Do not swallow gum or hard candy. This counts as a meal. You will need to wait 8 hours for your procedure.
When should I stop chewing tobacco or putting snuff in my mouth before my procedure?
Stop 6 hours before your procedure.
I was in a car accident and need emergency surgery. It has only been 4 hours since I ate. My doctor says I need the surgery now. Why do I not have to wait 8 hours?
Guidelines help doctors and patients decide about health care. Fasting guidelines are not meant to be the final decision. The risk of aspiration must be weighed against the risk of not having surgery quickly. Your care team may change the type of anesthesia you get to lower your risk.
If I take food through an enteral or nasogastric tube (gastric/stomach tube, enteral/jejunostomy tube), should I follow the same instructions?
Stopping feeds for 8 hours is best. People who check residual volumes, can stop feeds 4 hours before the procedure if the volumes are not going up. Stop feedings at the first sign of higher stomach residual volumes.
Continuous duodenal feedings have less risk of aspiration than stomach feedings. The urgency of the surgery and need for continuous nutritional support versus the higher risk of aspiration needs to be talked about with the patient and all providers involved in the care.
Why can I use apple jelly to take crushed medicines?
Apple jelly is made from apple juice that is boiled and cooled. This causes it to thicken. Apple juice is an approved clear fluid.
Plain apple jelly can be used to take crushed pills up to 2 hours before a procedure. Do not use pudding or apple sauce.
Who came up with the fasting guidelines?
They are based on research and expert opinion. The American Society of Anesthesiologists and the European Society of Anesthesiologists each have a task force to make them. Doctors in the Department of Anesthesia at the University of Iowa Health Care adapt these guidelines.