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Anaesthesia. 2019 Jan;74(1):83-88. doi: 10.1111/anae.14500. Epub 2018 Nov 30.

Pre-operative fasting in adults and children: clinical practice and guidelines.

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Department of Anaesthesia, Royal Surrey County Hospital NHS Foundation Trust, Guildford, UK.
Department of Anaesthesia, Great Ormond Street Hospital for Children, NHS Foundation Trust, London, UK.


It is widely recognised that prolonged fasting for elective surgery in both children and adults serves no purpose, adversely affects patient well-being and can be detrimental. Although advised fasting times for solids remain unchanged, there is good evidence to support a 1-h fast for children, with no increase in risk of pulmonary aspiration. In adults, a major focus has been the introduction of carbohydrate loading before anaesthesia, so that patients arrive for surgery not only hydrated but also in a more normal metabolic state. The latter attenuates some of the physiological responses to surgery, such as insulin resistance. As in children, there is no increase in risk of pulmonary aspiration. Further data are required to guide best practice in patients with diabetes.


adult anaesthesia; carbohydrate drinks; clear fluids; paediatric anaesthesia; pre-operative fasting


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