Toast and tea before elective surgery? A national survey on current practice

Area of Science:

• Anesthesiology
• Surgical Care

Background:

• The American Society of Anesthesiologists updated preoperative fasting guidelines, allowing clear liquids up to 2-3 hours and a light meal up to 6 hours before elective surgery for healthy adults.
• These updated guidelines aim to liberalize patient intake before procedures.

Purpose of the Study:

• To assess the adoption of new American Society of Anesthesiologists preoperative fasting guidelines by anesthesiologists in U.S. outpatient settings.
• To determine if institutional policies align with these liberalized fasting recommendations.

Main Methods:

• A national survey was distributed to the active membership of the Society for Ambulatory Anesthesia.
• The survey collected data on current practices and institutional policies regarding preoperative fasting.
• A response rate of 59.6% was achieved from an initial sample of 623 subjects.

Main Results:

• 62% of respondents reported institutional policies allowing clear liquids 2-3 hours before anesthesia induction.
• Only 35% of institutions had policies permitting a light breakfast 6 hours before elective surgery.
• Despite policy variations, 65% of anesthesiologists would proceed with surgery if a patient had a light meal 6 hours prior, 32% would delay, and only 3% would cancel.

Conclusions:

• The majority of U.S. anesthesiologists in outpatient settings have adapted their practice patterns to align with the updated American Society of Anesthesiologists preoperative fasting recommendations.
• These findings may encourage a global shift towards more liberal preoperative fasting protocols for healthy patients undergoing elective surgery.