Nil per os (NPO-nothing by mouth) after midnight has long been the standard of care for patients undergoing elective procedures. The American Society of Anesthesiologists (ASA) first recommended liberalization of NPO after midnight in 1999 and updated to the current guidelines (8 hours prior solid food, 6 hours prior a light meal of toast and clear liquids and 2 hours prior for clear liquids) in 2011. Liberal preoperative fasting has been implemented in most countries, however current studies reveal healthy adults are fasting from solid food on average of 14.5 hours, liquids 13 hours and clear liquids 12.5 hours before scheduled elective procedures (Kulshrestha, Mathews, Kapadia, & Sanwatsarkar, 2013). This prolonged fasting is not only
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Preoperative fluid intake is associated with increased feeling of well-being, reduces thirst and dryness of the mouth and, in some studies, less anxiety (Ljungqvist, & Soreide, 2003). There is considerable interest in the potential benefits of carbohydrate-rich drinks, not only in aiding recovery, but also in mitigating the effects of increased insulin resistance and dehydration which result from prolonged fasting (Falconer, Skouras, Carter, Greenway, & Paisley, 2013).
Compliance with the ASA guidelines is multifactorial. Physicians and patients may still believe that fasting from midnight is safer. Physicians may feel that patients are unable to adhere to complicated preoperative fasting instructions. Patient adherence may depend on work and sleep patterns, family eating times, personal routines, and transportation to the hospital.
Shime, Ono, Chihara, & Tanaka (2005) found that many anesthesiologists (56%) believed there was no benefit in changing traditional fasting routine; in addition they felt it may create confusion and lead to increased
Preoperative fluid intake is associated with increased feeling of well-being, reduces thirst and dryness of the mouth and, in some studies, less anxiety (Ljungqvist, & Soreide, 2003). There is considerable interest in the potential benefits of carbohydrate-rich drinks, not only in aiding recovery, but also in mitigating the effects of increased insulin resistance and dehydration which result from prolonged fasting (Falconer, Skouras, Carter, Greenway, & Paisley, 2013).
Compliance with the ASA guidelines is multifactorial. Physicians and patients may still believe that fasting from midnight is safer. Physicians may feel that patients are unable to adhere to complicated preoperative fasting instructions. Patient adherence may depend on work and sleep patterns, family eating times, personal routines, and transportation to the hospital.
Shime, Ono, Chihara, & Tanaka (2005) found that many anesthesiologists (56%) believed there was no benefit in changing traditional fasting routine; in addition they felt it may create confusion and lead to increased