• Skip to primary navigation
  • Skip to main content
  • Skip to footer

SAGES

Reimagining surgical care for a healthier world

  • Introduction
  • Preoperative
  • Intraoperative
  • Postoperative
  • Resources
    • Frequently Asked Questions (FAQ)
    • SMART Course Videos
    • Pathways
    • Implementation Timeline

Reduce preoperative fasting

Traditionally patients are “NPO after midnight” to reduce the risk of aspiration of gastric contents at induction of anesthesia. This results in a long period without hydration or nutrition, especially for cases booked later the following day. Oral intake of clear fluids up to 2 hours before surgery does not increase the risk of aspiration in healthy adults undergoing elective surgery (1) and may decrease anxiety, hunger and thirst while waiting for surgery (2). Anesthesia Society guidelines from multiple countries consistently recommended a 6 hour fast for solids and a 2 hour fast for clear fluids except in for patients with dysphagia, obstruction or gastroparesis.


For more information, see Chapter 4: Preoperative Fasting and Carbohydrate Treatment in The SAGES / ERAS® Society Manual of Enhanced Recovery Programs for Gastrointestinal Surgery


References:
1. Brady M, Kinn S, Stuart P. Preoperative fasting for adults to prevent perioperative complications. Cochrane Database Syst Rev. 2003;(4):CD004423.

2. Hausel J, Nygren J, Lagerkranser M, Hellström PM, Hammarqvist F, Almström C, Lindh A, Thorell A, Ljungqvist O. A carbohydrate-rich drink reduces preoperative discomfort in elective surgery patients. Anesth Analg. 2001 Nov;93(5):1344-50.


1,729

Share this:

  • Twitter
  • Facebook
  • LinkedIn
  • Pinterest
  • WhatsApp
  • Reddit

Related

Surgery Type
Bowel
Building Blocks
Preoperative

SAGES Enhanced Recovery

SAGES improves quality patient care through education, research, innovation and leadership, principally in gastrointestinal and endoscopic surgery.

Representing a worldwide community of more than 6,000 surgeons, SAGES sets the clinical and educational guidelines on standards of practice in various procedures, critical to enhancing patient safety and health.

SAGES Support

SAGES gratefully acknowledges Medtronic for its generous educational grant in support of the SMART Enhanced Recovery Program.

Preoperative
Intraoperative
Postoperative

SAGES Smart Task Force

  • Liane Feldman, Chair
  • Thomas Aloia, Co-Chair
  • Gina Adrales
  • Rajesh Aggarwal
  • Joselin Anandam
  • Conor Delaney
  • Diana Diesen
  • Justin Dimick
  • Julio Fiore Jr.
  • Gerald Fried
  • Pascal Fuchshuber
  • I. Gorgun
  • Alexis Grucela
  • Matthew Hutter
  • Edmundo Inga-Zapata
  • Rohan Joseph
  • Deborah Keller
  • Anne Lidor
  • David Liska
  • Sumeet Mittal
  • Charles Paget III
  • Michele Riordon
  • Vadim Sherman
  • Andrew Wright
  • Tonia Young-Fadok
  • Yulia Zak

Contact SAGES

Society of American Gastrointestinal and Endoscopic Surgeons
11300 W. Olympic Blvd Suite 600
Los Angeles, CA 90064 USA
webmaster@sages.org
Tel: (310) 437-0544

Find Us Around the Web!

  • Facebook
  • Twitter
  • YouTube

Important Links

SAGES 2023 Meeting Information

Healthy Sooner: Patient Information

SAGES Guidelines, Statements, & Standards of Practice

SAGES Manuals

 

  • taTME Study Info
  • Foundation
  • SAGES.TV
  • MyCME
  • Educational Activities

Copyright © 2023 Society of American Gastrointestinal and Endoscopic Surgeons