Outpatient Surgery Magazine

Wake Up to the Dangers of Sleep Apnea - October 2018 - Subscribe to Outpatient Surgery Magazine

Outpatient Surgery Magazine, providing current information on Surgical Services, Surgical Facility Administration, Outpatient Surgery News and Trends, OR Excellence and more.

Issue link: http://outpatientsurgery.uberflip.com/i/1039427

Contents of this Issue

Navigation

Page 52 of 116

Established practice Practice guidelines for pre-op fasting issued by the American Society of Anesthesiologists in 1999 said it was appropriate for patients to drink clear liquids at least 2 hours before elective procedures. The ASA reiterated that recommendation in its latest guideline update issued in 2011. "The guidelines were never intended to drive a change in practice habits or do away with NPO altogether," says anesthesiologist Joyce Wahr, MD, director of the University of Minnesota Health Preoperative Assessment Center. "They're intended to inform about when it's safe to anesthetize patients without having them aspirate." But fear of pulmonary aspiration remains a significant barrier to providers letting patients drink clear liquids before surgery, says TJ Gan, MD, MHS, FRCA, professor and chairman of the department of anesthesiology at Stony Brook (N.Y.) School of Medicine. "A major concern is that oral intake before surgery will increase residual gastric volume and a decrease in gastric pH, causing a higher risk of aspiration," he says. Dr. Gan has some advice for hesitant providers: Don't worry about it. Seriously. He says studies have shown that ingestion of clear liquids 2 hours before surgery results in smaller residual gastric volumes and higher gastric pH levels compared with longer fasts. In addition, the rate of gastric emptying in obese individuals is the same as it is in people of average weight, he says. "There is absolutely no risk in letting patients drink clear fluid up until 2 hours before surgery," he adds. "If fact, it promotes gastric emptying. It's actually safer." Saying no to NPO has been slow to catch on because health care is stuck in emphasizing what providers need to accomplish instead of O C T O B E R 2 0 1 8 • O U T PA T I E N T S U R G E R Y. N E T • 5 3

Articles in this issue

Archives of this issue

view archives of Outpatient Surgery Magazine - Wake Up to the Dangers of Sleep Apnea - October 2018 - Subscribe to Outpatient Surgery Magazine