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Review: evidence is lacking that adults given fluids 1.5 to 3 hours preoperatively have greater risks of aspiration or regurgitation than those given a standard fast

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 Q In adults, what are the effects of different preoperative fasting regimens (duration, type, and volume of permitted intake) on perioperative complications and patient wellbeing?

METHODS

Embedded ImageData sources:

Medline (1966 to August 2003), CINAHL (1982 to August 2003), the Cochrane Central Register of Controlled Trials (second quarter, 2003), and the UK National Research Register (August 2003); bibliographies of relevant studies and conference proceedings; and experts.

Embedded ImageStudy selection and assessment:

randomised controlled trials (RCTs) or quasi-RCTs that compared the effects of different preoperative fasting regimens in terms of duration of fast, type of permitted intake, and volume of permitted intake before general anaesthesia; included adults ⩾18 years of age; and reported postoperative complications. Studies of healthy patients having general anaesthesia or those at high risk of regurgitation or aspiration during anaesthesia (ie, patients who were pregnant, postpartum, obese, elderly, or had gastric disorders) were included. A standard fast was defined as nil by mouth from midnight before morning surgery and a small breakfast early in the morning before afternoon surgery. Intake of a small amount of …

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