Pediatric ambulatory anesthesia: NPO—Before or after surgery?

In the hope of reducing the risk of perioperative aspiration pneumonitis, a period of fasting, often of prolonged duration, became a routine feature of the preoperative preparation of ambulatory surgical patients. The premise is that fasting ensures gastric emptying. Following anesthesia and operation, patients frequently have been expected to demonstrate the ability to drink and retain clear liquids prior to hospital discharge. The belief has been that tolerating clear liquids will reduce the likelihood of the patient returning to the hospital with ongoing vomiting that results in dehydration. Recent investigations have raised doubts about both premises and prompted the systematic reappraisal of perioperative feeding practices.