A 2-hour preoperative fast for clear fluids and 6-hour fast for solids is safe, improves well-being, and preoperative carbohydrates reduce postoperative insulin resistance in elective surgery.
Does a 2-h preoperative fast for clear fluids and a 6-h fast for solids improve well-being and reduce insulin resistance compared to fasting after midnight in patients having elective operations?
Allowing clear fluids up to 2 hours before elective surgery and providing preoperative carbohydrates is safe and improves patient well-being and metabolic response compared to traditional fasting after midnight.
BACKGROUND AND METHODS: To avoid pulmonary aspiration, fasting after midnight has become standard in elective surgery, but recent studies have found no scientific support for this practice. Several anaesthesia societies now recommend a 2-h preoperative fast for clear fluids and a 6-h fast for solids in most elective patients. The literature supporting such fasting recommendations was reviewed. RESULTS: The recommendations are safe and improve well-being before operation, mainly by reducing thirst. A carbohydrate-rich beverage given before anaesthesia and surgery alters metabolism from the overnight fasted to the fed state. This reduces the catabolic response (insulin resistance) after operation, which may have implications for postoperative recovery. CONCLUSION: Most patients having elective operations can be allowed a free intake of clear fluids up to 2 h before anaesthesia. Preoperative carbohydrates reduce postoperative insulin resistance.
Ljungqvist et al. (Wed,) conducted a review in Elective surgery. 2-hour preoperative fast for clear fluids and 6-hour fast for solids; preoperative carbohydrates vs. Fasting after midnight was evaluated on Safety, well-being, and postoperative insulin resistance. A 2-hour preoperative fast for clear fluids and 6-hour fast for solids is safe, improves well-being, and preoperative carbohydrates reduce postoperative insulin resistance in elective surgery.