We spend a lot of time and effort attempting to prevent aspiration during anesthesia, and advising patients to avoid eating or drinking before surgery is an established practice. In this episode, Jeremy and Mark discuss new guidelines from an international multidisciplinary panel that challenges some long established NPO practices. Some of the big shake-ups include allowing clear liquids up to the time of surgery, permitting a small amount of milk in coffee and still calling it a clear liquid, and promoting salivation stimulants such as gum or a lollipop both before and after surgery. Tune in to check out these new guidelines and decide for yourself if it’s time to shake things up!

References

1.    Rüggeberg A, El-Boghdadly K, Bilotta F, et al. Peri-operative fasting in adults: an international, multidisciplinary consensus statement. Anaesthesia. Published online February 9, 2026. doi:10.1111/anae.70130

2.     MENDELSON CL. The aspiration of stomach contents into the lungs during obstetric anesthesia. Am J Obstet Gynecol. 1946;52:191-205. doi:10.1016/s0002-9378(16)39829-5

3.    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: a report by the American Society of Anesthesiologist Task Force on Preoperative Fasting. Anesthesiology. 1999;90(3):896-905. doi:10.1097/00000542-199903000-00034

4.    Joshi GP, Abdelmalak BB, Weigel WA, et al. 2023 American Society of Anesthesiologists Practice Guidelines for Preoperative Fasting: Carbohydrate-containing Clear Liquids with or without Protein, Chewing Gum, and Pediatric Fasting Duration. Anesthesiology. 2023;138(2):132-151. doi:10.1097/ALN.0000000000004381

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The Nurse Anesthesia Podcastis for educational and informational purposes only. It does not constitute medical. We continuously strive for accuracy, however, medicine is constantly evolving, and clinical decisions should always be made based on current guidelines, institutional policies, and individual patient considerations. The views expressed are those of the hosts and guests, and Do NOT necessarily reflect the opinions of any affiliated institutions. Listeners should consult their own healthcare providers before making any medical decisions. 

Music by Alex Grohl