Long Fasting Before Surgery? Not Anymore

Friday, March 1, 2002

Long Fasting Before Surgery? Not Anymore (NAPSA)—Is it really necessary to fast after midnight the night before surgery? Probably not, according to the American Society of Anesthesiology (ASA). Current fasting guidelines, revised in 1999, allow for a shorter, more comfortable fasting period. However, a study published in the May 2002 issue of American Journal of Nursing shows that many hospitals have still not changed their “NPO after midnight”ritual. Fasting is necessary because the stomach should be as empty as possible during surgery to reduce the chance of vomiting and choking. If vomiting occurs and stomach contents get into the lungs (known as “pulmonary aspiration”), patients can get very sick and maydie...although a rare complication with modern anesthesia. The ASA’s guidelines are for healthy patients of all ages having elective surgery. They are based on studies involving thousands of patients and provide specific recommendations for clear liquids (which leave the stomach almost immediately) and solids, which first are broken down and may take many hours before leaving the stomach. But studies have shown no difference in stomach content between patients fasting after midnight Today, fasting for a long period before surgery may bethingof thepast, according to a new study published in the May 2002 issue of the American Journal of Nursing. But for more than 100 years, patients have been told to fast before surgery. In medicalterms, this is called NPO, or nil peros (Latin for “nothing by mouth”). Anecdotally, a surgical patient had a sign overher bed thatread “NPO"in bright red letters. When her husband askedits meaning, she looked bewildered, peeked underthe covers, smiled and exclaimed, “No panties on!” and patients drinking clear liquids up to two hours before surgery. (Guidelines for solids are stricter: six to eight hours before surgery.) So, if your surgery is at 1 p.m., you may be able to have a drink until 11 a.m. While each case is unique, remember: Find out the time of your surgery and get detailed fasting instructions. e Ask why your fasting instructions are the samefor clear liquids andsolids. Tell your doctor or nurse which medicines you take regularly, and ask which ones to take the morning of your surgery. Ask if you may have something to drink or ice chips if surgery is delayed.

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