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Identifying the Role for Preoperative Fasting In Healthy Adults and Pediatric Patients Undergoing Elective Surgical Procedures


Identifying the role for preoperative fasting                                                         2


It has been a long time tradition for physicians to order “NPO” or nothing by mouth after midnight for patients undergoing elective surgery before a procedure.  Contrary to popular belief, the American Society of Anesthesiologists (ASA) introduced practice guidelines, published in 1999, which challenges that years old tradition.  The use of general anesthesia can reduce the reflex that prevents aspiration of gastric contents and juices.  It is often advisable for patients to refrain from eating or drinking after midnight to prevent aspiration pneumonitis.  According to the ASA guidelines and several publications and research projects studied throughout the years, “healthy” adults are allowed clear liquids (clear juices, water, tea, carbonated beverages, etc) within two hours of surgery and pediatric patients age 2-17 years are allowed clears within four hours of surgery.  Light breakfast foods such as tea and toast are allowed if consumed within six hours before administration of anesthesia.  Even though these guidelines have been published since 1999, multiple surgeons, physicians, and anesthesiologists still implement the old time rule of “NPO after midnight.”  The question of whether or not these guidelines should be standardized are still being researched, taking into consideration other factors such as emergent situations that may require a patient to have emergent surgery.  Research continues to provide knowledge and implement the awareness of these practice guidelines to physicians and nurses to educate and improve patient care and satisfaction in an already stressful, anxiety-ridden situation while waiting for surgery.


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