Clear liquid before surgery

Q: In enhanced recovery after surgery (ERAS), holding clear liquids 12 hours prior to surgery showed early recovery?

A) True

B) False

Answer: B

Although conventional practice asks patients to be NPO 10-12 hours prior to surgery, evidence in the literature for ERAS favors encouraging the consumption of clear liquids until two to four hours before general anesthesia. Most fasting guidelines from international anesthesia societies now favor this practice.

American Society of Anesthesiologists, 2017 guidelines favor 2 hours margin for clear liquids, excluding alcohol. In fact, chewing gum is allowed up until induction. Also, healthy adults are encouraged to drink carbohydrates containing clear liquids. These guidelines apply to healthy patients, not in labor and undergoing elective surgery.

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References:

1. 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 Task Force on Preoperative Fasting and the Use of Pharmacologic Agents to Reduce the Risk of Pulmonary Aspiration. Anesthesiology 2017; 126:376.

2. Joshi GP, Abdelmalak BB, Weigel WA, et al. 2023 American Society of Anesthesiologists Practice Guidelines for Preoperative Fasting: Carbohydrate-containing Clear Liquids with or without Protein, Chewing Gum, and Pediatric Fasting Duration-A Modular Update of the 2017 American Society of Anesthesiologists Practice Guidelines for Preoperative Fasting. Anesthesiology 2023; 138:132.