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Preoperative Fasting: Will the Evidence Ever Be Put into Practice?

Crenshaw, Jeannette T. DNP, RN, IBCLC, LCCE, NEA-BC

AJN, American Journal of Nursing:
doi: 10.1097/01.NAJ.0000406412.57062.24
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Abstract

Overview: Decades of research support the safety and health benefits of consuming clear liquids, including those that are carbohydrate rich, until a few hours before elective surgery or other procedures requiring sedation or anesthesia. Still, U.S. clinicians routinely instruct patients to fast for excessively long preoperative periods. Evidence-based guidelines, published over the past 25 years in the United States, Canada, and throughout Europe, recommend liberalizing preoperative fasting policies. To improve patient safety and health care quality, it's essential that health care professionals abandon outdated preoperative fasting policies and allow available evidence to guide preanesthetic practices.

Keywords: aspiration, fasting, gastric fluid volume, pneumonia, preoperative care, preprocedural fasting, preoperative carbohydrate loading

In Brief

To improve patient safety and health care quality, it's essential that health care professionals abandon outdated preoperative fasting policies and allow available evidence to guide practice.

Author Information

Jeannette T. Crenshaw is a clinical assistant professor and a member of the graduate faculty for the master's in nursing administration program at the University of Texas at Arlington College of Nursing. She is also a family educator at Texas Health Presbyterian Hospital Dallas. Contact author: jeannettecrenshaw@tx.rr.com. The author has disclosed no potential conflicts of interest, financial or otherwise.

The author would like to thank Elizabeth H. Winslow, PhD, RN, FAAN, M. Lou Marsh, MD, ABA, and Rodney Hicks, PhD, RN, FNP, FAANP, FAAN, for reviewing earlier versions of the manuscript.

© 2011 Lippincott Williams & Wilkins, Inc.