Preoperative fasting recommendations not followed - AORN Foundation

AORN Journal, July, 2002

Evidence-based preoperative fasting policies should be developed, and these policies should be monitored for their effectiveness, according to an article published in the May 2002 issue of the American Journal of Nursing. Nurses, physicians, and administrators should work together to ensure that this occurs and educate staff members about such policies.

Research was conducted to determine whether the revised American Society of Anesthesiology (ASA) recommendations regarding preoperative fasting have actually changed practice. These revised guidelines allow clear liquids to be consumed up to two hours before elective surgery, light solids (eg, toast) to be consumed up to six hours before elective surgery, and a heavy meal to be consumed up to eight hours before elective surgery.

The sample consisted of 155 participants. Researchers interviewed participants and found that on average, patients fasted from liquids 12 hours before surgery and from solids 14 hours before surgery. Ninety-one percent of participants were required to remain NPO after midnight before their surgery, and 79% of those whose surgery was scheduled for noon or later were required to remain NPO after midnight. Some patients refrained from ingesting liquids 20 hours before surgery and solids 37 hours beforehand, times significantly longer than recommended by the ASA.

E H Winslow, J T Crenshaw, "Original research: Preoperative fasting: Old habits die hard," American Journal of Nursing 102 (May 2002) 36-44.