Effect of liberal preop fasting policy on fasting duration and patient well-being, safety

Editor's Note

This study, led by researchers at the University Medical Center Utrecht in the Netherlands, finds that a liberal preoperative fasting policy allowing adults scheduled for general anesthesia to drink clear fluids until arrival in the OR was associated with reduced fasting duration and improved patient well-being with regard to preoperative thirst and postoperative nausea and vomiting (PONV).

Of 76,451 patients included in the study, 59,036 followed the standard policy (clear fluids allowed until 2 hours before anesthesia), and 16,815 followed the liberal policy (clear fluids allowed until arrival in the OR).

Findings after implementation of the liberal fasting policy included:

• Overall median fasting time decreased significantly from 3:07 to 1:20 hours.
• Incidence of regurgitation changed from 18 to 24 in 10,000 patients.
• Incidence of aspiration changed from 1.7 to 2.4 in 10,000 patients.
• Thirst feelings decreased (37% vs 46%).
• PONV decreased from 10.6% to 9.4%.
• Administration of antiemetics decreased from 11.0% to 9.5%.

Results suggest that surgical procedures in patients who drink clear fluids within 2 hours before undergoing general anesthesia should not be postponed or canceled, the researchers say.