From the Guidelines
It is recommended to avoid consuming soda (carbonated beverages) for at least 2 hours before receiving anesthesia, as stated in the guidelines for monitoring and management of pediatric patients before, during, and after sedation for diagnostic and therapeutic procedures 1. This precaution applies to all clear liquids, including water, fruit juices without pulp, clear tea, and black coffee. The primary concern is that carbonated beverages can increase stomach acidity and gas, potentially raising the risk of aspiration during anesthesia. Aspiration occurs when stomach contents enter the lungs, which can cause serious complications, such as pneumonia or acute respiratory distress syndrome. Most anesthesiologists follow fasting guidelines that recommend no solid food for 6-8 hours before surgery and no clear liquids for 2 hours before anesthesia, as outlined in the American Society of Anesthesiologists' practice guidelines for preoperative fasting and the use of pharmacologic agents to reduce the risk of pulmonary aspiration 1. These restrictions help ensure an empty stomach, reducing the risk of regurgitation and aspiration while under anesthesia when protective airway reflexes are suppressed. Additionally, carbonated beverages may cause bloating or discomfort, which could complicate the surgical experience. Some studies have suggested that drinking clear fluids up to 3 hours before surgery has no significant effect on gastric volume or gastric pH, but these findings may not be generalizable to all patients, particularly those with certain medical conditions or taking certain medications 1. Always follow your specific pre-operative instructions provided by your healthcare team, as individual circumstances may require different fasting periods. It is essential to note that the health evaluation before sedation should include a review of the patient's medical history, medication use, and other factors that may increase the risk of complications during anesthesia, as emphasized in the guidelines for monitoring and management of pediatric patients before, during, and after sedation for diagnostic and therapeutic procedures 1. By following these guidelines and recommendations, healthcare providers can help minimize the risks associated with anesthesia and ensure the best possible outcomes for their patients. Key points to consider include:
- Avoid consuming soda and other clear liquids for at least 2 hours before anesthesia
- Follow specific pre-operative instructions provided by your healthcare team
- Inform your healthcare provider about any medical conditions, medications, or other factors that may increase the risk of complications during anesthesia
- Ensure that your healthcare provider is aware of any allergies or sensitivities to medications or foods.
From the Research
Soda Consumption Before Anesthesia
- The study 2 found that a patient who drank 600 ml of a carbonated, glucose-rich soft drink 2 hours before surgery had absorbed nearly all of it within those 2 hours, suggesting that 2 hours may be sufficient for preoperative fasting after soft drink intake.
- However, the American Society of Anesthesiologists (ASA) and the European Society of Anaesthesiology and Intensive Care (ESAIC) recommend a minimum 2-hour fast after ingestion of clear liquids before general anesthesia, regional anesthesia, or procedural sedation and analgesia, as stated in 3.
- It is also worth noting that consuming clear liquids, such as water, apple juice, or black tea, 2-3 hours before surgery does not increase gastric residual volume or risk for aspiration, according to 4.
Effects of Fasting on Patients
- Prolonged fasting can result in patients arriving in the operating room in an uncomfortable state, being thirsty, hungry, and potentially affecting hemodynamic stability, as mentioned in 3.
- Allowing patients to consume carbohydrate-rich clear liquid beverages may reduce postoperative nausea and vomiting and improve patient reports of anxiety, hunger, and thirst, as suggested by 4.
Prevention of Postoperative Nausea and Vomiting
- Metoclopramide has been shown to be effective in preventing postoperative nausea and vomiting (PONV) in patients receiving general anesthesia, with a reduced incidence of 24 h PONV, nausea, and vomiting, as found in 5.
- Alternative methods, such as acupressure, have also been suggested as effective in reducing intraoperative nausea and vomiting, as compared to intravenous metoclopramide in 6.