CHANGING PREOPERATIVE FASTING POLICIES - IMPACT OF A NATIONAL CONSENSUS

Background: Liberalisation of preoperative fasting rules has been disc ussed and recommended in the anaesthesia literature in recent years. I n Norway, a national consensus on this issue was reached in 1993. The aim of the present study was to investigate whether a national consens us on fasting recommendations led to a change in fasting policies in N orwegian anaesthesia departments. Methods: A questionnaire on preopera tive fasting routines was sent to all Norwegian anaesthesia department s in 1993 and repeated in 1996. Results: Written local guidelines for preoperative fasting were present in 85% of the institutions in both s urveys. Of the hospitals, 69% had changed their local guidelines after the national consensus. In 1996 more hospitals allowed less than 6 h fasting for clear liquids in children (93% versus 71% in 1993; P<0.005 ). A similar tendency was noted in adults (79% versus 63% in 1993; P=0 .1). In contradiction to the national guidelines, 31% of the departmen ts reported that they allowed less than 6 h fasting after a light brea kfast in the morning of surgery in 1996. The corresponding number for 1993 was 21% (ns). Conclusion: The new, consensus-based national fasti ng guidelines have been associated with a change towards more liberal fasting policies in Norwegian departments of anaesthesia. However, as not all local changes were supported by the national consensus, other sources of information were used when local policies were decided.