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Abstract：
OBJECTIVE: Preoperative fasting guidelines are generalized to elective procedures and usually do not distinguish between the ambulatory and inpatient setting. Prevalence of aspiration is low while prolonged preoperative fasting is common clinical reality. Recently, changes in preoperative fasting guidelines have been widely discussed.
RESULTS: Rates of prolonged clear fluid fasting (>4 h) prior to surgery are reported in up to 80% of patients with mean fasting duration of up to 16 h and beyond. Prolonged fasting may result in adverse effects such as intraoperative hemodynamic instability, postoperative delirium, patient discomfort, and extended hospital length of stay. Liberal approaches allowing clear fluids up to 1 h prior to anesthesia or until premedication/call to the operating room have shown no increase in adverse events among children. Various anesthesia societies now encourage clear fluid intake up to 1 h prior to pediatric elective anesthesia. Similar reports in the adult cohort are scarce.
CONCLUSIONS: Allowing sips of water until call to the operating room may help reducing prolonged preoperative fasting and improving patient comfort while keeping a flexibility in operating room schedule. The feasibility and safety of a liberal clear fluid fasting regimen among adults undergoing elective anesthesia needs to be evaluated in future studies.
RESULTS: Rates of prolonged clear fluid fasting (>4 h) prior to surgery are reported in up to 80% of patients with mean fasting duration of up to 16 h and beyond. Prolonged fasting may result in adverse effects such as intraoperative hemodynamic instability, postoperative delirium, patient discomfort, and extended hospital length of stay. Liberal approaches allowing clear fluids up to 1 h prior to anesthesia or until premedication/call to the operating room have shown no increase in adverse events among children. Various anesthesia societies now encourage clear fluid intake up to 1 h prior to pediatric elective anesthesia. Similar reports in the adult cohort are scarce.
CONCLUSIONS: Allowing sips of water until call to the operating room may help reducing prolonged preoperative fasting and improving patient comfort while keeping a flexibility in operating room schedule. The feasibility and safety of a liberal clear fluid fasting regimen among adults undergoing elective anesthesia needs to be evaluated in future studies.
摘要：
目的：术前禁食指南一般为选择性手术，通常不区分门诊和住院。误吸的患病率较低，而术前长时间禁食是常见的临床现实。最近,术前禁食指南的变化已被广泛讨论。
结果：据报道，多达80％的患者在手术前长时间禁食（>4小时），平均禁食时间长达16小时及以上。长时间禁食可能会导致不良反应，如术中血流动力学不稳定，术后谵妄,患者不适,并延长住院时间。自由的方法允许在麻醉前1小时或直到术前用药/到手术室为止清除液体，儿童中的不良事件没有增加。现在，各种麻醉协会都鼓励在小儿选择性麻醉前1小时摄入透明液体。成人队列中的类似报告很少。
结论：允许在呼叫手术室之前小口喝水可能有助于减少术前长时间禁食，提高患者舒适度，同时保持手术室时间表的灵活性。在接受择期麻醉的成年人中，自由透明液体禁食方案的可行性和安全性需要在未来的研究中进行评估。
结果：据报道，多达80％的患者在手术前长时间禁食（>4小时），平均禁食时间长达16小时及以上。长时间禁食可能会导致不良反应，如术中血流动力学不稳定，术后谵妄,患者不适,并延长住院时间。自由的方法允许在麻醉前1小时或直到术前用药/到手术室为止清除液体，儿童中的不良事件没有增加。现在，各种麻醉协会都鼓励在小儿选择性麻醉前1小时摄入透明液体。成人队列中的类似报告很少。
结论：允许在呼叫手术室之前小口喝水可能有助于减少术前长时间禁食，提高患者舒适度，同时保持手术室时间表的灵活性。在接受择期麻醉的成年人中，自由透明液体禁食方案的可行性和安全性需要在未来的研究中进行评估。
