Fasting Before Surgery Might Be A Thing Of The Past
Fasting before surgery has long been a routine requirement intended to prevent patients from vomiting while under anesthesia, a situation that could lead to serious complications like pneumonia if stomach contents are inhaled. However, a new comprehensive review suggests that this traditional practice may not be medically necessary.
Published in the journal Surgery, the review examined data from 17 studies conducted between 2016 and 2023, involving nearly 1,800 surgical patients. The findings showed that the risk of inhaling vomit during surgery was extremely low and not significantly different between those who fasted and those who did not. Specifically, only four cases occurred among patients who ate or drank shortly before surgery, compared to seven among those who followed standard fasting guidelines.
Dr. Edward Livingston, a professor of surgery at UCLA’s David Geffen School of Medicine and lead researcher on the study, emphasized how uncomfortable prolonged fasting can be for patients. He noted that while fasting is a universal practice in hospitals, it may be outdated and unsupported by modern medical evidence.
The review also highlighted a surprising gap in the literature: many current fasting policies stem from tradition rather than solid clinical data. Most guidelines do not cite original research that justifies long fasting periods, and many patients are likely abstaining from food and drink longer than necessary.
To address this, researchers recommend new clinical trials to test shorter fasting times using modern tools, such as gastric ultrasound, to assess the contents of the stomach before sedation. These techniques could help tailor pre-surgery fasting guidelines to individual needs, improving patient comfort without compromising safety.
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