For my 31 years of Orthopaedic Surgery practice and ten years of training before that, EVERYONE followed the axiom that an empty stomach before surgery was absolutely essential to avoid potentially fatal aspiration. But now it appears that may be completely wrong.
A fascinating article in the Thursday July 13 Wall Street Journal by physician Hakim Bouzamondo cites a variety of studies showing that outcomes are better if a nutritious drink is consumed immediately before surgery, and that the risk of aspiration is in fact virtually nonexistent. He describes that the practice of consuming a presurgical nutritious drink is common in Europe although still not allowed in general in the United States. The only cautionary note on this article is that the author is a VP of research and development for Abbott’s nutrition division. In other words, his employer would make a tremendous amount of money if hospitals started feeding their surgery patients before surgery as he advocates. At the very least though the article is a wake-up call to at least look at objective data on the issue, and see if we could be improving outcomes if we reversed one of the longest standing and seemingly most inviolable surgical safety rules.
