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AMBULATORY ANESTHESIA

Toast and Tea Before Elective Surgery? A National Survey on Current Practice

Department of Anesthesiology, University of Michigan School of Medicine, Ann Arbor, Michigan

A more tolerant approach to preoperative fasting guidelines for healthy adults undergoing elective surgery was recently recommended by a task force appointed by the American Society of Anesthesiologists. This recommendation liberalizes the intake of clear liquids and specifically allows a light breakfast (e.g., toast and tea or coffee) up to 6 h before elective surgery. We conducted a national survey to determine whether anesthesiologists giving anesthesia in an outpatient setting in the United States were currently following these recommendations, and whether institutional policy reflects these new guidelines. The population consisted of the entire active membership of the Society for Ambulatory Anesthesia, providing an initial sample size of 623 subjects. Most conservatively calculated, we had a response rate of 59.6%. A total of 62% of the respondents said they have an institutional policy in place to allow clear liquids orally 2–3 h before the induction of anesthesia. However, only 35% of the respondents said their institutions had a policy in place allowing a light breakfast 6 h before elective surgery. Nevertheless, only 3% of the responders said they would cancel the operation if a patient actually arrived at the facility after consuming a light breakfast, such as toast and tea 6 h before elective surgery, 32% would delay surgery to later that day, and 65% would proceed without delay. We concluded that most anesthesiologists practicing outpatient anesthesia in the United States have already changed their practice pattern to conform to the recent recommendations of the American Society of Anesthesiologists task force on preoperative fasting time.

Implications: Findings of this national survey conducted among active members of the Society for Ambulatory Anesthesia may encourage anesthesiologists throughout the world to take a more liberal attitude toward allowing clear liquids 2–3 h and a light breakfast 6 h before an elective surgery in healthy patients.

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