When preparing for surgery, patients often receive a long list of instructions, including fasting advice. While traditionally patients were instructed to follow a strict “nil by mouth” policy, recent research has led to new updates in these guidelines. Let us dive in and learn more how you can safely prepare for your upcoming surgical procedure. When should you drink water, sip it, or avoid it completely.

New guidelines for pre-operative fasting

Traditionally, patients were instructed to follow a strict “nil by mouth” policy before surgery. However, recent research has led to updated guidelines that allow for more flexible hydration practices. The European Society of Anaesthesiology now recommends adults can safely sip clear fluids up until elective surgery. This approach, known as “liberalised fasting”, has been shown to improve patient outcomes without increasing risks.

Despite these advances in medical science, multiple audits have found that patients are routinely fasting for much longer than recommended by the current pre-operative guidelines before elective surgeries, with the issue being even more pronounced for emergency surgeries.

The importance of hydration before surgery

Hydration plays a fundamental role in maintaining your overall health, but it becomes even more critical when you are preparing for surgery. Here are a few key reasons why staying hydrated is essential:

1. Improving comfort: Adequate hydration will reduce thirst and dry mouth and help decrease the likelihood of postoperative nausea and vomiting – common complaints among patients after surgery. This will lead to a more comfortable experience overall.
2. Aiding recovery: Well-hydrated patients often experience a quicker recovery process. Hydration helps support various bodily functions, including wound healing and the elimination of anaesthesia from your system.
3. Maintaining blood volume and pressure: Proper hydration ensures that your blood volume and pressure remain stable. This stability is crucial during surgery, particularly for the safe administration of anaesthesia and for maintaining organ function.
4. Reducing the risk of complications: Dehydration can lead to serious complications, such as low blood pressure, increased heart rate, and even kidney problems. Staying hydrated helps minimise these risks, as well as leads to better insulin resistance, reduced anxiety and stress response, providing a safer surgical experience overall.

How to stay hydrated before surgery

1. Follow your Consultant's instructions: Always adhere to the specific guidelines provided by your surgical team. They may vary depending on your individual case and the type of procedure you are undergoing.
2. Choose clear fluids: When allowed to drink, opt for clear fluids such as water, clear tea without milk, or clear apple juice. Avoid dairy products, pulpy juices, and carbonated beverages.
3. Sip, do not gulp: If permitted to drink close to your surgery time, take small sips rather than large amounts at once. This can help prevent discomfort and reduce the risk of aspiration during anaesthesia.

When water might not be recommended

While proper hydration is beneficial, it is crucial to follow your healthcare provider’s instructions precisely. Drinking when you are not supposed to can lead to the postponement of your surgery or increase risks during the procedure.

Please note, there are situations where drinking water before surgery is not advised:

• Gastrointestinal surgeries: For procedures involving the digestive tract, such as colonoscopies or colorectal surgeries, patients may be instructed to avoid all fluids for a longer period. This ensures a completely empty digestive system for the procedure.
• Emergency surgeries: In cases of urgent or emergency procedures, patients may be advised not to drink anything to minimise the risk of aspiration during anaesthesia.
• Certain medical conditions: Patients with conditions that delay gastric emptying, such as gastroparesis or severe reflux disease, may be advised to stop drinking water earlier than the standard two-hour cut-off.

Heed your own Specialist’s advice

Staying hydrated before surgery is more than just a recommendation – it is a critical step in ensuring a safe and successful surgical experience. By maintaining proper hydration, you can help reduce the risk of complications, improve your recovery, and enhance your overall well-being.

However, you must remember that every patient and procedure is unique. Your surgical team will provide you with personalised instructions tailored to your specific needs. By following their guidance and staying appropriately hydrated, you can help ensure a smoother surgical experience and a more comfortable recovery.

If you have any questions about hydration and fasting guidelines for your surgery, please refer to the information provided in your Admission Letter.

At New Victoria Hospital, we offer a wide range of treatments, from Orthopaedics and ENT to Urology and Gynaecology. If you are considering having your surgery performed at New Victoria Hospital, get in touch with our Self Pay team on 020 8949 9090 or Admissions team on 020 8949 9010.