Study: Can you drink water before surgery?
Although current guidelines issued by professional medical societies still recommend stopping fluid intake two hours before surgery, an increasing number of hospitals are adopting a more modern approach. One of the pioneers in this field is the Helios Hospital Emil von Behring in Berlin, where this topic has been the focus of intensive research for many years. Encouraged by its own consistently positive experience, Helios Hospital Hildesheim has now joined a new scientific study. The study specifically investigates potential adverse events, including aspiration — when stomach contents enter the lungs during vomiting — which can lead to aspiration pneumonia.
Why not drinking before surgery can be harmful
For many years, the standard rule was simple: patients were not allowed to drink anything for many hours before surgery. “In everyday clinical practice, we see that most patients remain without food and fluids much longer than recommended. Fasting for eight to twelve hours is still common despite more relaxed guidelines, and this creates significant risks,” explains Dr. Alfred Flaccus, Head of the Anesthesia Outpatient Clinic at Helios Hospital Hildesheim, who has more than 30 years of experience in anesthesiology. He adds:
“Prolonged fasting leads to dehydration, which can cause numerous undesirable effects, including circulatory instability with severe drops in blood pressure during surgery as well as episodes of confusion.”
Older adults are particularly susceptible to dehydration-related delirium. These episodes of confusion, which often persist for some time, have been shown to negatively affect postoperative recovery. “The scientific evidence is already clear: maintaining optimal hydration significantly reduces the incidence of delirium. Monitoring patients' fluid balance becomes especially important during the warmer months,” says the senior consultant, adding, “The medical community agrees that the benefits of drinking fluids clearly outweigh the potential risks.”
Results of the new protocol
At Hospital in Hildesheim, patients are not only allowed to drink before surgery — they are actively encouraged to do so.
Working together with all surgical departments, the anesthesia team has introduced a simple but effective concept. During the preoperative consultation, patients receive a Preoperative Fasting Card, which clearly explains the recommendations and explicitly encourages them to continue drinking clear fluids until they are called to the operating room.
The results from two years of routine clinical practice have been highly encouraging: there has been no increase in aspiration events — that is, the accidental inhalation of stomach contents into the lungs during anesthesia.
Aiming to establish new standards
By participating in the new study, the Hildesheim team hopes to promote wider adoption of this approach.
“Our goal is for unrestricted intake of clear fluids before surgery to be incorporated into the next edition of the official clinical guidelines,” says anesthesiologist and emergency physician Dr. Alfred Flaccus.
Patients at Helios Hildesheim Hospital are already benefiting from this modern practice. Because they are allowed to drink until shortly before surgery, the period of thirst before the procedure has been significantly reduced, while the risks during surgery have also been lowered.
Read more:
Do you need more information about Helios Hospitals or want to schedule your treatment?
