ASA Updates Guidelines for Preoperative Fasting

The American Society of Anesthesiologists published updated guidelines on preoperative fasting in the March issue of Anesthesiology, adding a requirement that anesthesia departments oversee all sedation and anesthesia delivered in a facility or hospital.

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The guidelines are largely based on scientific evidence, as noted in the document. The guidelines state that for elective cases, intake of clear fluids is allowed up to two hours before induction, breast milk is permissible up to four hours prior and intake of solids and infant formula should cease six hours before anesthesia.

For emergency department physicians, the guidelines present a significant change, since ED physicians generally rely on the American College of Emergency Physicians guidelines to inform their sedation practices. The ACEP guidelines use two hours for clear liquids, like ASA, but three hours for all other oral intake. Experts are working to develop “consensus guidelines” that merge the ASA and ACEP guidelines while acknowledging the differences between ED physician practice and anesthesiologist practice.

Read the Anesthesiology blog post on the updated guidelines for preoperative fasting.

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