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

Coffee with creamer is considered by many preoperative fasting guidelines to be a nonclear liquid with a recommended fasting time of 6 hours before initiating anesthesia. There is limited evidence to support these recommendations, yet they frequently result in cases being delayed or canceled. This study looked to determine if the addition of creamer to coffee leads to a clinically significant delay in gastric emptying time beyond the currently recommended 2-hour minimum fasting period for clear liquids, such as black coffee.

This was a nonrandomized control trial (NRCT) with alternating assignment for the creation of the two groups. Healthy volunteers were assigned to drink either 16-ounces (473 mL) of black coffee or 16-ounces (473 mL) of black coffee with two standard half-and-half creamers. Participants were then scanned every hour until they returned to a grade zero antrum in the supine and right lateral decubitus positions.

Of the 32 participants who received black coffee 47% (n = 15) had emptied their stomach after 1 hour, 94% (n = 30) after 2 hours, and 100% (n = 32) had empty stomachs after 3 hours. Of the 33 participants who received coffee with creamer 42% (n = 14) had emptied their stomach after 1 hour, 97% (n = 32) after 2 hours, and 100% (n = 33) had empty stomachs after 3 hours.

This study demonstrated no difference in the gastric emptying times of young, healthy volunteers when two half-and-half creamer pods were added to 16 ounces (473 mL) of black coffee. These findings are important in adding evidence to the need for further research into the current pre-operative guidelines that recommend 6 hours of fasting with the consumption of coffee with creamer before the induction of anesthesia.