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Preoperative fasting

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Background and methods:

To avoid pulmonary aspiration, fasting after midnight has become standard in elective surgery, but recent studies have found no scientific support for this practice. Several anaesthesia societies now recommend a 2-h preoperative fast for clear fluids and a 6-h fast for solids in most elective patients. The literature supporting such fasting recommendations was reviewed.

Results:

The recommendations are safe and improve well-being before operation, mainly by reducing thirst. A carbohydrate-rich beverage given before anaesthesia and surgery alters metabolism from the overnight fasted to the fed state. This reduces the catabolic response (insulin resistance) after operation, which may have implications for postoperative recovery.

Conclusion:

Most patients having elective operations can be allowed a free intake of clear fluids up to 2 h before anaesthesia. Preoperative carbohydrates reduce postoperative insulin resistance. Copyright © 2003 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.
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Document Type: Review Article

Affiliations: 1: Centre of Gastrointestinal Disease, Ersta Hospital and Department of Surgery, Huddinge University Hospital, Karolinska Institute, Stockholm, Sweden 2: Department of Anaesthesia and Intensive Care Medicine, Rogaland Central and University Hospital, Stavanger, Norway

Publication date: 2003-04-01

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