Comparing Black Coffee to Coffee With Creamer in Gastric Emptying Time: A Nonrandomized Control Trial

Area of Science:

• Anesthesiology
• Gastroenterology
• Preoperative Medicine

Background:

• Current preoperative fasting guidelines often classify coffee with creamer as a non-clear liquid, requiring a 6-hour fast.
• Limited evidence supports these extended fasting times, leading to frequent case delays and cancellations.
• This study investigates the impact of creamer on gastric emptying compared to black coffee.

Purpose of the Study:

• To determine if adding creamer to coffee significantly delays gastric emptying beyond the 2-hour clear liquid fasting period.
• To provide evidence for revising current preoperative fasting recommendations.

Main Methods:

• A nonrandomized control trial with alternating assignment was conducted.
• Healthy volunteers consumed either 16 ounces of black coffee or 16 ounces of coffee with two standard half-and-half creamers.
• Gastric emptying was assessed hourly using scans until a grade zero antrum was achieved.

Main Results:

• No significant difference in gastric emptying times was observed between black coffee and coffee with creamer groups.
• After 2 hours, 94% of the black coffee group and 97% of the coffee with creamer group had empty stomachs.
• All participants in both groups had empty stomachs within 3 hours.

Conclusions:

• Adding two standard half-and-half creamers to 16 ounces of coffee does not clinically alter gastric emptying times in healthy volunteers.
• These findings support the need for evidence-based reevaluation of preoperative fasting guidelines for coffee with creamer.
• Current 6-hour fasting recommendations for coffee with creamer may be unnecessarily restrictive.