Thursday, October 6, 2011

Best Foods For The Operating Room

Okay, right off the bat, I'm going to give you the official rule about eating in the operating room. NO FOOD IS EVER, EVER, EVER ALLOWED IN THE OPERATING ROOM! Got that? Never, ever, ever.

Now that I have that out of the way, let's talk about eating in the O.R. Yes we all know it is wrong. But sometimes for humanitarian reasons, anesthesiologists are forced to eat in the operating room. We try to eat what we can get in the doctor's lounge in the morning (hence the RAPERS reputation), but that alone can't possibly last through a ten to twelve hour workday. The nurses get lunch and snack breaks because they have strong union rules. The surgeons get to eat between cases, all the while complaining about the long turn around time they are suffering through. Anesthesiologists? Nobody is there to give us a break. When the surgeon leaves after putting in his last skin staple, he is heading down to the cafeteria. In the meantime, we have to wake up the patient, take him to recovery, give report and make sure the patient is stable, come back to the O.R. to set up for the next case, interview the next patient in preop and digest his entire life history in less than five minutes if possible, start an IV, get my medications ready, wheel the patient into the operating room, induce the patient, then call the surgeon to let him know we are ready for him. All in under 30 minutes, preferably under 20. So you can see, there is little opportunity for anesthesiologists to eat outside the operating room. Therefore we have to be creative in order to keep from getting malnourished and hypoglycemic. It would be unseemly to have an anesthesiologist collapse behind the ether screen because his blood glucose is 32.

So what kinds of food work best for munching in the O.R.? There are several rules I think should be followed. The number one rule is the food should emit no odors. Anything that will draw attention to your eating is absolutely unforgivable. Thus something like popcorn is out. Coffee is the rare exception that most staff in the O.R, including the surgeons, have brought in with little protest.  Next the food must be easily handled. No knife and fork or other utensils should be necessary to eat it while working.  The food should be compact in size. It should be able to fit under your mask while eating, preferably bite size pieces so you're not holding a piece of food in your hands between bites. No greasy foods. That means french fries and nachos are out. Leaving greasy fingerprints on your machine and anesthesia records cannot be tolerated. No loud foods. Potato chips commit the double felony of greasy and loud. So they're out. Nothing too watery. That can leave a mess and make you need to go to the bathroom in the middle of the case. Finally, no choking hazards. The surgeons don't like it if they have to unglove to perform a Heimlich maneuver on you.

Okay, so now that we have the basic rules for the kinds of food that should not be eaten in the operating room, let's look at a list of stuff that should pass muster. Some are sweet, some are savory, but there should be something here for everybody.

1. Power bars or granola bars. This is the standard by which all other O.R. foods are compared. There are infinite varieties to choose from. They are small, compact, and easy to eat. They are quiet when chewed and they fit easily into your briefcase. Just remember to get the ones that don't have crinkly wrappers. The wrappers will draw too much attention to your activities.

2. Grapes. They're sweet, healthy, and a good source of hydration in a compact size. Definitely get the seedless variety as you don't want to be spitting out seeds all over the O.R. floor. Just make sure you don't eat too many of them lest you need to urinate during the case.

3. String cheese. A good source of calcium and protein. Small and easy to eat. The kids love them and I do too.

4. Peanut butter and jelly sandwich. This is a surprisingly good fit for the operating room. Cut into small squares, they fit easily into the mouth. It is a quiet food, loaded with protein, satisfies both the savory and sweet tooths, and doesn't leave crumbs behind. Just be sure nobody in the room has a severe case of peanut allergies.

5. Juice box. This is good for a quick hydration and glucose pick me up. The small straw that comes with the juice box makes it easy to drink under your mask. Multiple varieties to choose from. Just try to avoid the slurping sound it makes when the box is almost empty.

6. Fig newtons. An ideal cookie for the operating room. They don't have a strong smell like chocolate chips cookies can have. They are bite sized. And they leave few crumbs behind.

7. Small crackers. Examples include Cheez-Its and bite-sized Ritz crackers with or without fillings. Being bite-sized helps make sure there are no crumbs all around the anesthesia work station. Also little munching noise is made when you can chew a whole cracker with your mouth closed.

8. Small pretzels. Mini pretzels work well. You can fit an entire one in your mouth at one time making little noise and few crumbs. They are loaded with carbs to keep your energy going. They are also low in fat and taste good. What else could you ask for?

Those are my dietary recommendations for replenishing yourself in the operating room. Again, you should never, ever, ever eat in the O.R. But if you have too, you can't go wrong with any of these choices. Have I left anything out? Please give me some of your suggestions in the comments below. I'm always willing to try something new from my fellow anesthesiologists.


  1. Which type of surgeries or specialty anesthesiologist tend to have the longest cases? Like every other case is 5+ hours? Do they get breaks to get lunch/dinner?

  2. Some specialties tend to have long cases. Cardiac cases and liver transplants come to mind. At least with heart cases, once the patient is on the pump, the anesthesiologist is generally relieved from minute to minute monitoring and can take a break. Liver transplant cases are intense throughout the entire procedure and there is no break whatsoever. Unless you have a resident working with you, you're generally stuck in the room for the four to eight hours it takes to perform the transplant.

    Then there are the marathon spine cases, the abdominal tumor cases, and the lengthy plastic surgery cases. If you want long anesthesia cases, there are plenty to choose from.

  3. I just have to say that I laughed SOOO hard reading this post!! I am current resident and have always thought about eating (although I never would given I am still in training and do not want to be fired) but this post reminds me of a Seinfeld bit or something.
    Great post.

  4. Shame on you all. There are plenty of cases where the surgeons and nurses are scrubbed for 8 to 12 hours without break. Although not ideal, this comes with the territory. YOU PICKED IT. If you aren't getting a break then you need to talk to your dept. head and resolve your scheduling and manpower issues. You certainly shouldn't be compromising the sterility of the OR and putting the patient's safety at risk as a means of solving your problem.

    1. Anonymous You seriously need to get a sense of humor. You sound like one of those unrealistic JACHO jerkoffs who know nothing about clinical day to day OR practice but have the nerve to attempt to write a cook book so that a monkey could be trained to work in the OR. Lighten up.

    2. Puleese! Sterility in the O.R.? Blood, guts, poop & worse? The anesthesiologist is at far greater risk than the patient! There IS a greater risk to a patient when those responsible for his life are fatigued, have low blood sugar or poor reasoning skills due to lack of protein.
      I've worked in the O.R. for 30 years. Most of what this guy posted is not an exageration! AND...what planet are you from? Who's going to pay for all this "manpower" you are talking about?!