Preoperative fasting: rules of good conduct and recommendations

The rules of pre-operative fasting

The rules of the pre-operative fast are consensual and are the subject of recommendations by the learned societies of anesthesia and intensive care (4).

In order to minimize the risk of inhalation, it is therefore recommended to respect a period of 2 hours between the intake of clear liquids and the start of the operation. The term “clear liquids” includes alcohol-free, particle-free and protein-free liquid.

Typically we can cite water, tea, coffee or fruit juice without pulp (apple juice). It is possible to add sugar in small quantities. The risk of inhalation increases when the meal consists of solid foods.

Thus, after a meal, not rich, it is recommended to maintain a preoperative fast of 6 hours before the intervention. Schematically, for a patient undergoing carpal tunnel surgery on an outpatient basis at 9 a.m. in the morning, the patient is offered to take his usual meal the night before and then to have a liquid breakfast exclusively between 6 a.m. and 7 a.m. the morning of the operation.

After a rich meal (meat, fried food, etc.), it is probably necessary to prolong fasting for up to 8 hours before the operation. During the pre-anaesthesia consultation, it is the role of the anesthetist to insist on the need to stop smoking in the perioperative period to reduce the anesthetic risk and promote healing.

On the other hand, the current recommendations do not recommend respecting any young person when it comes to vaping.

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