Department of Anesthesia Preoperative Fasting Guidelines
Fasting guidelines apply to patients of all ages receiving anesthesia from the Department of Anesthesia, including monitored anesthesia care. Guidelines do not guarantee complete gastric (stomach) emptying.
Guidelines may need to be modified for patients with co-existing diseases or conditions that might affect stomach emptying or fluid volume [e.g., pregnancy, obesity, diabetes, hiatal hernia, gastroesophageal reflux disease (acid reflux disease), ileus or bowel obstruction, emergency care, or enteral (stomach) tube feeding] or for patients in whom airway management might be difficult. Risk of aspiration is greater for these patients.
UNLESS OTHERWISE INSTRUCTED, BEFORE ELECTIVE PROCEDURES, THE MINIMUM DURATION OF FASTING SHOULD BE:
- 2 HOURS AFTER CLEAR FLUIDS *
- 4 HOURS AFTER INGESTION OF BREAST MILK
- 6 HOURS AFTER A LIGHT MEAL (SUCH AS TOAST AND A CLEAR FLUID) OR AFTER INGESTION OF INFANT FORMULA OR NONHUMAN MILK
- 8 HOURS AFTER A MEAL THAT INCLUDES MEAT, FRIED OR FATTY FOODS
* Examples of clear fluids include water, real or artificial fruit juices without pulp, carbonated beverages, clear tea, infant electrolyte solutions (Pedialyte®), and black coffee without any type of creamer:
- no more than two ounces for patients up to 5 years of age;
- no more than four ounces for patients 5 through 13 years of age;
- no more than eight ounces (1 cup) for patients over 13 years of age.
* Clear fluids do not include alcohol.
* Infants (less than 1 year of age) are a special case. To prevent dehydration infants should receive clear fluids prior to their surgery or procedure. An infant should complete a breast feeding about 4 hours prior to the surgery/procedure or should receive clear liquids (e.g. Pedialyte®) about 2-3 hours prior to surgery/procedure. This often means that the infant will need to be awakened from sleep.
Adapted, in part, from reports by the American Society of Anesthesiologists Copyright © 1999 and the Canadian Anesthesiologists' Society Copyright © 2009
Questions? Call the Anesthesia Desk at (319) 356-2724 Some cases may start earlier than scheduled, and times should be adjusted accordingly.
Revised: April 2010