What Are the Guidelines for Pre-operative Fasting?

As seen in the March/April issue of Advancing Care

Patients must strictly follow fasting rules, also known as NPO Guidelines (NPO means “nothing by mouth,” from the Latin nil per os), prior to admission for procedures requiring anesthesia to avoid risks, including pulmonary aspiration, respiratory compromise, regurgitation and postoperative dehydration.

For children, the “2-4-6-8 rule” is used, says Samuel Barst, MD, Chief of Pediatric Anesthesia at Maria Fareri Children’s Hospital, a member of the Westchester Medical Center Health Network (WMCHealth):

2 hours before: Last clear fluids (water, ginger ale, apple juice). Chicken broth and milk are not clear fluids. 4 hours before: Last breastfeeding. 6 hours before: Last bottle feeding with formula. 8 hours before: Last solid food (even a single potato chip!).

Adults follow the ”2-6-8 rule,“ says Debra Lederman, DO, Chair, Quality Management, Department of Anesthesia at Westchester Medical Center, the flagship of WMCHealth:

2 hours before: Last clear fluids (water, apple/white grape juice, tea without milk). 6 hours before: “Light meal” (dry toast/no fat/butter allowed, clear liquid). 8 hours before: Full meal (may include fats).

Your physician will evaluate your medical records, perform a physical exam and engage in age-appropriate discussions about anesthesia and what to expect. All patients should follow the specific instructions of their physician.