Pre-operative fasting guidelines: An update

Pre-operative fasting aims to reduce residual gastric volume and acidity prior to surgery or other nonsurgical procedures requiring general anaesthesia, regional anaesthesia or intravenous sedation. This helps to prevent regurgitation and aspiration of gastric contents. Majority of serious cases of pulmonary aspiration occurs in emergency cases particularly trauma, obstetrics, abdominal surgery and pain. Patients with history of symptomatic gastro-esophageal reflux, hiatus hernia, morbid obesity, difficult airway are at increased risk of regurgitation and aspiration of gastric contents. Increased fasting time leads to decreased injury if aspiration occurs1.Clinical studies show the incidence of pulmonary aspiration is 1 in 100002.