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What is the appropriate fasting time before ambula-tory surgery that necessitates an anesthetic?
The prescribed preoperative fasting period for both fluids and solids for patients scheduled for ambulatory surgical procedures should be identical to that required for an inpatient who is scheduled to receive an anesthetic. The ASA have released guidelines that recommend 8 hours for solids, 6 hours for a light meal (toast and tea), 4 hours for breast milk, and 2 hours for clear liquids. Eight ounces of orange juice without pulp or coffee without milk has not been demonstrated to increase gastric volume. In fact, both resting gastric volume and acidity may be reduced, which may further decrease the incidence and potentially devas-tating sequelae of an intraoperative aspiration.
Other benefits result from decreasing the fasting time in preoperative patients. Patients allowed to drink clear fluids are more content while they impatiently wait for a surgical procedure that was either delayed or was scheduled for the latter hours of the day. Thirst is relieved, and hunger may be diminished. Furthermore, the ingestion of glucose-containing solutions may also prevent relative degrees of hypoglycemia noted in both healthy patients and those with limited reserves. It is important to emphasize that medications required for the maintenance of homeostasis such as blood pressure and cardiac drugs can be taken orally up to 1 hour before surgery with an ounce of water.
Fasting guidelines should not be made on a case-by-case basis but rather should be reflected in facility- or institution-wide guidelines.
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