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Preoperative fasting: will the evidence ever be put into practice?

Jeannette T Crenshaw¹

¹University of Texas at Arlington College of Nursing, USA. jeannettecrenshaw@tx.rr.com

The American Journal of Nursing

|September 20, 2011

Summary

Patients can safely drink clear, carbohydrate-rich liquids until hours before surgery. Current U.S. guidelines recommend shorter preoperative fasting periods, urging clinicians to adopt evidence-based practices for better patient outcomes.

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Area of Science:

Anesthesiology
Surgical Care
Patient Safety

Background:

Extensive research confirms the safety and benefits of clear liquid consumption before procedures.
Current U.S. clinical practice often involves excessively long preoperative fasting periods.
International evidence-based guidelines advocate for liberalized preoperative fasting policies.

Purpose of the Study:

To highlight the discrepancy between evidence-based guidelines and current U.S. clinical practices regarding preoperative fasting.
To advocate for the adoption of updated, evidence-based preoperative fasting protocols.

Main Methods:

Review of decades of research on clear liquid consumption before anesthesia.
Analysis of evidence-based guidelines published over the past 25 years in North America and Europe.
Assessment of current U.S. preoperative fasting policies.

Main Results:

Decades of research support the safety of consuming clear liquids, including carbohydrate-rich options, up to a few hours before elective surgery.
Evidence-based guidelines consistently recommend shorter preoperative fasting durations.
U.S. clinicians frequently adhere to outdated, prolonged preoperative fasting instructions.

Conclusions:

Outdated preoperative fasting policies should be replaced with evidence-based practices.
Liberalizing preoperative fasting improves patient safety and healthcare quality.
Healthcare professionals must integrate current evidence into preanesthetic care.