Key result
Preoperative administration of 150 ml of water 2 hours prior to surgery significantly reduced gastric fluid volume compared to overnight fasting (5.5 ± 3.70 ml vs 17.1 ± 8.2 ml).
Why the study?
Does oral administration of 150 ml of water 2 hours prior to surgery improve gastric fluid volume and pH compared to overnight fasting in ASA I and II patients undergoing elective surgery?
RCT (n=100)
randomly assigned
Does oral administration of 150 ml of water 2 hours prior to surgery improve gastric fluid volume and pH compared to overnight fasting in ASA I and II patients undergoing elective surgery?
Absolute Event Rate: 5.5% vs 17.1%
p-value: p=statistically significant
Allowing 150 ml of water 2 hours prior to surgery significantly reduces gastric fluid volume compared to overnight fasting without affecting pH, supporting more relaxed fasting guidelines.
Supports allowing clear fluids 2 hours preoperatively in ASA I-II patients; extends RCT evidence for liberalized fasting guidelines.
Fasting before general anaesthesia aims to reduce the volume and acidity of stomach contents, thus reducing the risk of regurgitation and aspiration. Recent guidelines have recommended a shift in fasting policies from the standard 'nil per oral from midnight' to a more relaxed policy of clear fluid intake a few hours before surgery. The effect of preoperative oral administration of 150 ml of water 2 h prior to surgery was studied prospectively in 100 ASA I and II patients, for elective surgery. Patients were randomly assigned to two groups. Group I (n = 50) was fasting overnight while Group II (n = 50) was given 150 ml of water 2 h prior to surgery. A nasogastric tube was inserted after intubation and gastric aspirate was collected for volume and pH. The gastric fluid volume was found to be lesser in Group II (5.5 ± 3.70 ml) than Group I (17.1 ± 8.2 ml) which was statistically significant. The mean pH values for both groups were similar. Hence, we conclude that patients not at risk for aspiration can be allowed to ingest 150 ml water 2 h prior to surgery.
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Dalal et al. (2010) conducted an RCT in Elective surgery (n=100). Water vs. Fasting overnight was evaluated on Gastric fluid volume (p=statistically significant). Preoperative administration of 150 ml of water 2 hours prior to surgery significantly reduced gastric fluid volume compared to overnight fasting (5.5 ± 3.70 ml vs 17.1 ± 8.2 ml).
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