There was no evidence to suggest a shortened fluid fast results in an increased risk of aspiration, regurgitation or related morbidity compared with the standard 'nil by mouth from midnight' fasting policy. Permitting patients to drink water preoperatively resulted in significantly lower gastric volumes. Clinicians should be encouraged to appraise this evidence for themselves and when necessary adjust any remaining standard fasting policies (nil-by-mouth from midnight) for patients that are not considered 'at-risk' during anaesthesia.
[The effect of preoperative oral fluid intake on the volume and pH of gastric contents in elective surgical patients--a comparison of tea with apple juice].
This study aimed to investigate the effect of 150 ml of either tea or apple juice on the volume and pH of gastric contents in 40 elective surgical patients, ranging in age from 18 to 70 years. They were given diazepam 5 approximately 10 mg and roxatidine 75 mg orally 2 hours before the start of isoflurane anesthesia or modified neuroleptic anesthesia. Immediately following the induction of anesthesia with thiopental and vecuronium, a nasogastric tube was placed to aspirate the gastric content to measure its volume and pH. The volume and pH of gastric contents were 6.4 +/- 8.5 ml, 6.0 +/- 2.2 in tea group and 17.1 +/- 18.4 ml, 4.4 +/- 2.6 in apple juice group, respectively. There was a significant difference in the gastric volume between the two groups (P < 0.05), while no significant difference in gastric pH was observed. This result suggests that apple juice is not appropriate as preoperative drink because apple juice increases gastric contents, and may cause aspiration pneumonia.