[Restrict or enforce the preoperative clear liquid intake?: preface and comments]

Area of Science:

• Anesthesiology
• Surgical Patient Care

Context:

• Traditional preoperative fasting guidelines restrict clear liquid intake, causing patient discomfort like thirst.
• Despite American Society of Anesthesiologists (ASA) guidelines since 1999, these restrictions persist in many Japanese hospitals.
• The introduction of Enhanced Recovery after Surgery (ERAS) protocols in 2005, originating from Northern Europe, challenges traditional fasting.

Purpose:

• To review the evidence and rationale behind allowing preoperative clear liquid intake.
• To highlight the integration of preoperative fluid intake within ERAS protocols.
• To discuss the evolution of preoperative fluid management practices.

Summary:

• Historically, anesthesiologists mandated clear liquid restriction preoperatively, despite patient discomfort and questionable efficacy.
• The ASA published guidelines in 1999, but adoption has been slow, particularly in Japan.
• ERAS protocols emphasize preoperative clear liquid intake as a key factor for patient recovery.

Impact:

• Facilitates a shift towards evidence-based preoperative fluid management.
• Promotes patient comfort and potentially reduces surgical stress.
• Encourages wider adoption of ERAS principles in surgical care pathways.