Major fasting guidelines allow healthy adults having elective surgery to drink clear fluids until two hours before anaesthesia. Yet worldwide, patients commonly go far longer without fluid, often from midnight. Prolonged fasting adds thirst, discomfort and dehydration without clear benefit. Check that local instructions give a two-hour clear-fluid time, and that list changes do not leave patients fasting for hours longer than needed.
- Allow clear fluids until two hours before elective anaesthesia in healthy adults.
- Replace nil by mouth from midnight instructions with specific times.
- When a list is delayed, let patients drink again where it is safe.
- Apply individual judgement for delayed gastric emptying, including GLP-1 receptor agonist use.
Why it matters
Most patients still fast for many hours longer than any guideline asks.
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