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Is preoperative fasting necessary?

S Popilskis1, P Danilo, H Acosta

  • 1Institute of Comparative Medicine, Columbia University College of Physicians and Surgeons, New York, NY 10032.

Journal of Medical Primatology
|September 1, 1992
PubMed
Summary
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Prolonged fasting does not significantly alter gastric volume or acidity. However, histamine (H2) antagonists like cimetidine and ranitidine effectively reduce gastric volume and increase gastric pH before surgery.

Area of Science:

  • Anesthesiology
  • Gastroenterology
  • Pharmacology

Background:

  • Gastric volume and acidity are critical factors in anesthesia safety.
  • Fasting protocols aim to minimize aspiration risk.
  • Histamine (H2) antagonists are used to reduce gastric acid production.

Purpose of the Study:

  • To evaluate the efficacy of prolonged fasting versus H2 antagonists in altering gastric parameters.
  • To compare the effects of cimetidine and ranitidine on gastric volume and pH in a preclinical model.

Main Methods:

  • 56 baboons were randomly assigned to four groups: 14-hour fast, water intake 3 hours pre-surgery, cimetidine pre-treatment, or ranitidine pre-treatment.
  • Gastric volume and pH were measured under general anesthesia.
  • Statistical analysis was performed to compare group differences.

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Main Results:

  • No significant difference in gastric volume or pH was observed between prolonged fasting and water intake groups.
  • Both cimetidine and ranitidine significantly reduced gastric volume (P < 0.02).
  • Both H2 antagonists significantly increased gastric pH (P < 0.02).

Conclusions:

  • Prolonged withholding of oral fluids is ineffective in reducing gastric volume or increasing gastric pH.
  • Histamine (H2) antagonists are effective in reducing gastric residual volume and increasing gastric pH, offering a potential benefit in anesthesia.
  • H2 antagonists represent a viable strategy for managing gastric acidity in surgical patients.