Pre-operative fasting guidelines: an update

Abstract

"Liberal pre-operative fasting routines have been implemented in most countries. In general, clear fluids areallowed up to 2 h before anaesthesia, and light meals up to 6 h. The same recommendations apply for childrenand pregnant women not in labour. In children <6 months, most recommendations now allow breast- or formulamilk feeding up to 4 h before anaesthesia.Recently, the concept of pre-operative oral nutrition using a special carbohydrate-rich beverage has also gainedsupport and been shown not to increase gastric fluid volume or acidity. Based on the available literature, ourTask Force has produced new consensus-based Scandinavian guidelines for pre-operative fasting. What is stillnot clear is to what extent the new liberal fasting routines should apply to patients with functional dyspepsia orsystematic diseases such as diabetes mellitus. Other still controversial areas include the need for and effect offasting in emergency patients, women in labour and in association with procedures done under ¿deep sedation¿.We think more research on the effect of various fasting regimes in subpopulations of patients is needed beforewe can move one step further towards completely evidence-based pre-operative fasting guidelines."