Permitted does not mean consumed: Real-world drinking behaviour after the implementation of a liberal fasting...

Area of Science:

• Anesthesiology
• Patient Care

Background:

• Liberal preoperative fasting protocols permit clear-fluid intake up to 1 hour before anesthesia.
• Current policies define allowed intake, not actual consumption.
• Real-world drinking behavior under these protocols is not well understood.

Purpose of the Study:

• To characterize real-world patient fluid intake under liberal preoperative fasting protocols.
• To assess the impact of protocol reinforcement and expanded clear fluid options.

Main Methods:

• Descriptive observational study following liberal clear-fluid fasting protocol implementation.
• Patient-reported last fluid intake recorded at anesthesia induction (4 and 8 months).
• Exploratory substudy: serial measurement of fluid consumption over 1 hour in 25 patients.

Main Results:

• 64% of patients (37/58) reported drinking within 1 hour pre-anesthesia at 4 months.
• After protocol reinforcement and adding black coffee, 70% (51/73) reported drinking within 1 hour at 8 months.
• Exploratory substudy showed highly heterogeneous drinking patterns, with some patients consuming no fluids despite availability.

Conclusions:

• Liberal fasting protocols do not standardize patient preoperative fluid intake behavior.
• Actual preoperative fluid consumption is often limited, despite permissive protocols.
• Findings impact interpretation of permitted intake in physiological and protocol contexts.