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Fasting guidelines of international anesthesia societies

Fasting guidelines of international anesthesia societies
Country, year Fasting requirements at time of induction Comments
American Society of Anesthesiologists, 2017[1]
  • 2 hours clear liquids, excluding alcohol
  • 4 hours breast milk
  • 6 hours nonhuman milk, formula, light meal
  • 8 hours or more for fatty meal, fried food, meat
  • Healthy patients, not in labor, elective surgery
  • Light meal defined as toast or cereal with clear liquid
European Society of Anesthesiology and Intensive Care[2,3] Adults:
  • 2 hours clear liquids
  • 6 hours milk, solid food
  • Chewing gum and sucking hard candy allowed up until induction
  • Encourage oral fluid up to 2 hours
Children:
  • 1 hour clear liquids
  • 3 hours breast milk
  • 4 hours formula or nonhuman milk, light breakfast (weak recommendations)
  • 6 hours other solid food
  • Encourage oral fluid up until fasting time
Australian and New Zealand College of Anaesthetists[4]
  • 1 hour clear fluid (≤3 mL/kg/hour) for infants and children
  • 2 hours clear liquids adults
  • 3 hours breast milk for infants <6 months
  • 4 hours formula for infants <6 months
  • 6 hours breast milk, formula, limited solid food for children >6 months and adults
  • Up to 400 mL of clear liquid up to 2 hours prior to induction for adults is likely safe
Association of Anaesthetists in Great Britain and Ireland[5]
  • 2 hours clear liquids
  • 4 hours breast milk
  • 6 hours solid food, formula and cow's milk
  • Gum chewing treated as clear
Canadian Anesthesiologists' Society[6]
  • 2 hours clear liquids
  • 4 hours breast milk
  • 6 hours light meal, infant formula or nonhuman milk
  • 8 hours meat, fried or fatty food
 
Scandinavian Society of Anaesthesiology and Intensive Care Medicine[7]
  • 2 hours clear liquids
  • 4 hours breast milk and infant formula
  • 6 hours solid food and cows milk
  • 2 hours chewing gum and any tobacco product
  • Up to 1 hour prior to induction, 150 mL of water
  • 2 hours for preoperative carbohydrate drinks intended for preoperative nutrition
German Society of Anesthesiology and Intensive Care[8]
  • 2 hours clear liquids
  • 4 hours breast milk and infant formula
  • 6 hours meal
 
Pediatric societies
Joint statement from Association of Paediatric Anaesthetists of Great Britain and Ireland, European Society for Paediatric Anaesthesiology, L'Association Des Anesthésistes-Réanimateurs Pédiatriques d'Expression Française[9]
  • 1 hour clear liquids for children up to 16 years of age
  • Encourage intake of clear liquids
Canadian Pediatric Anesthesia Society[10]
  • 1 hour clear liquids for children
  • Encourage intake of clear liquids
The Society for Paediatric Anaesthesia of New Zealand and Australia[11]
  • 1 hour clear liquids for children
  • Encourage intake of clear liquids
GERD: gastroesophageal reflux disease.
References:
  1. Practice Guidelines for Preoperative Fasting and the Use of Pharmacologic Agents to Reduce the Risk of Pulmonary Aspiration: Application to Healthy Patients Undergoing Elective Procedures: An Updated Report by the American Society of Anesthesiologists Task Force on Preoperative Fasting and the Use of Pharmacologic Agents to Reduce the Risk of Pulmonary Aspiration. Anesthesiology 2017; 126:376.
  2. Smith I, Kranke P, Murat I, et al. Perioperative fasting in adults and children: guidelines from the European Society of Anaesthesiology. Eur J Anaesthesiol 2011; 28:556.
  3. Frykholm P, Disma N, Andersson H, et al. Pre-operative fasting in children: A guideline from the European Society of Anaesthesiology and Intensive Care. Eur J Anaesthesiol 2022; 39:4.
  4. Australian and New Zealand College of Anaesthetists. Guideline on pre-anaesthesia consultation and patient preparation. Available at: https://www.anzca.edu.au/getattachment/d2c8053c-7e76-410e-93ce-3f9a56ffd881/PS07-Guideline-on-pre-anaesthesia-consultation-and-patient-preparation (Accessed on September 8, 2021).
  5. Association of Anaesthetists of Great Britain and Ireland. Pre-operative Assessment and Patient Preparation - The Role of the Anaesthetist. Available at: https://anaesthetists.org/Home/Resources-publications/Guidelines/Pre-operative-assessment-and-patient-preparation-the-role-of-the-anaesthetist-2 (Accessed on October 8, 2021).
  6. Dobson G, Chow L, Filteau L, et al. Guidelines to the Practice of Anesthesia - Revised Edition 2020. Can J Anaesth 2020; 67:64.
  7. Søreide E, Eriksson LI, Hirlekar G, et al. Pre-operative fasting guidelines: an update. Acta Anaesthesiol Scand 2005; 49:1041.
  8. Verbandsmitteilung DGAI. Praeoperatives Nuechternheitsgebot bei elektiven Eingriffen. Anaesthesiol Intensivmed 2004; 12:722.
  9. Thomas M, Morrison C, Newton R, Schindler E. Consensus statement on clear fluids fasting for elective pediatric general anesthesia. Paediatr Anaesth 2018; 28:411.
  10. Rosen D, Gamble J, Matava C, Canadian Pediatric Anesthesia Society Fasting Guidelines Working Group. Canadian Pediatric Anesthesia Society statement on clear fluid fasting for elective pediatric anesthesia. Can J Anaesth 2019; 66:991.
  11. Society for Paediatric Anaesthesia in New Zealand and Australia. Available at: https://www.anzca.edu.au/getattachment/d2c8053c-7e76-410e-93ce-3f9a56ffd881/PS07-Guideline-on-pre-anaesthesia-consultation-and-patient-preparation (Accessed on October 22, 2021).
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