Current theory and practice: a study of pre-operative fasting

This study examines the practice of pre-operative fasting in relation to fluids. Patients scheduled for elective surgery, and qualified nurses and anaesthetists were studied using a structured and semi-structured interview technique. Supporting the findings of previous studies, this study demonstrated that despite universal agreement between nurses and anaesthetists that patients routinely fast for longer than the recommended time for fluids, pre-operative fasting regimes are derived from routine practice. It was found that a single regime was used to encompass a range of operating times, leading to extended periods of fasting. These periods ranged from three and three quarter hours to 29 hours, with a mean and median fasting time of 11 hours. Fifty per cent of the anaesthetists in the study knew about recent research in this area of practice, but none of the nurses were aware of these recommendations. The absence of a hospital policy offering clear guidelines on the management of pre-operative fasting contributed to the prolonged periods for which patients were fasted. The study also highlighted the fact that patients receive insufficient information regarding the purpose and nature of their fast.