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Preoperative Fasting Guidelines
Minimum fasting timeMaterial ingested
2 hClear liquids (e.g., water, fruit juice without pulp, soda, tea without milk, black coffee)
4 hBreast milk
6 h
  • Infant formula
  • Nonhuman milk
  • Light meal (e.g., tea and toast)
>6 h
  • Intake of fried/fatty foods may delay gastric emptying.
  • The individual practitioner should consider this and make a determination of the appropriate fasting period
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  • In addition to the above guidelines, practitioners must also take into consideration factors that may prolong gastric emptying (e.g., emergent procedure, pregnancy, diabetes, hiatal hernia, GERD, ileus, bowel obstruction, obesity [controversial])
  • There is no evidence that smoking one cigarette prior to surgery increases the risk of aspiration
  • It is generally accepted that trauma or acute illness slows gastric emptying. These patients are considered “full stomach” even if >8 hours have elapsed since the last meal

1. American Society of Anesthesiologists Committee. Practice guidelines for preoperative fasting and the use of pharmacologic agents to reduce the risk of pulmonary aspiration: application to healthy patients undergoing elective procedures: an updated report by the American Society of Anesthesiologists Committee on Standards and Practice Parameters. Anesthesiology. 2011;114(3):495–511.   [PubMed: 21307770]

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