Preoperative Fasting Guidelines: Where Are We Now? Findings From Current Practices in a Tertiary Hospital.

PURPOSE: New evidence-based fasting guidelines have been published in recent years. However, while water and solid food fasting times before anesthesia are recommended to be 2 and 6 hours, respectively, these times are often longer in clinical practice. This study aimed to investigate the awareness and implementation of the fasting guideline recommendations among nurses and anesthesiologists, as well as evaluate the actual fasting durations in patients in a tertiary hospital.

DESIGN: A cross-sectional study was used.

METHODS: Questionnaires were designed to collect the knowledge of fasting time among registered anesthesiologists and nurses. Data on the instructed and actual fasting durations among patients scheduled for elective surgery were evaluated.

FINDINGS: Approximately half of the nurses indicated that solid food fasting durations were shorter than 6 hours or longer than 8 hours, and two-thirds indicated that clear fluid fasting durations were shorter than 2 hours or longer than 4 hours. However, in clinical practice, nurse-instructed fasting durations were longer than what they knew was optimal. The anesthesiologists also prescribed longer fasting durations than the minimum fasting duration recommended. The actual fasting durations of the patients were significantly longer than the nurse-instructed fasting durations for solid food (13.41 ± 2.64 vs 9.87 ± 2.20 hours, P < .001) and clear fluids (10.27 ± 3.67 vs 8.98 ± 2.90 hours, P < .001). The nurse-instructed durations were significantly longer than the anesthesiologist-instructed durations according to the statements of patients (9.87 ± 2.20 vs 9.00 ± 2.00 hours for solid food, P < .001; 8.98 ± 2.90 vs 6.15 ± 3.25 hours for clear fluids, P < .001).

CONCLUSIONS: Excessive fasting durations were observed among patients. Anesthesiologists and nurses must work together to ensure that updated fasting instructions are implemented in routine clinical practice.