Kaffee, Kippe, Kaugummi – Mythen und Fakten zur präoperativen Nüchternheit

Zusammenfassung

Zur Reduktion des Aspirationsrisikos gelten strikte Vorgaben für präoperative Nüchternzeiten. Für klare Flüssigkeiten (2 Stunden) und feste Nahrung (6 Stunden) sind diese eindeutig definiert; der Einfluss von Kaffee, Rauchen und Kaugummi wird dagegen kontrovers diskutiert. Dieser Beitrag zeigt, welche Mythen zur präoperativen Nüchternheit bestehen und durch welche Fakten sich das Risiko verlässlich einordnen lässt.

Abstract

Consumption of clear liquids (including coffee and orange juice without pulp) up to 2 hours before the start of anaesthesia is unproblematic. Contrary to the recommendations of the professional societies, the intake of beverages containing milk (up to 50% of the total volume) in small quantities seems to be harmless. Drinks containing alcohol can considerably delay emptying of the stomach. Immediate preoperative nicotine consumption has no influence on the risk of aspiration, but short-term nicotine abstinence in patients with CHD can reduce the risk of intraoperative myocardial ischaemia. Chewing gum has no effect on the pH of gastric juice, but the gastric fluid volume is slightly increased. Cancelling surgery because of preoperative chewing of gum by a patient is not justified despite increased gastric fluid volume.

Schlüsselwörter

präoperative Nüchternheit - Kaffee - Rauchen - Kaugummikauen - Magenentleerung

Key words

preoperative fasting - coffee - smoking - chewing gum - gastric emptying

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