Study Objectives: To prospectively assess the impact of a liberalized preop
erative fasting policy on operating room (OR) utilization.
Study Design: Prospective cohort study involving data collection before and
after a change in nil persons (NPO) policy.
Setting: Academic teaching hospital.
Patients: 5,420 consecutive outpatients and AM admissions
Interventions: Data collection was done on all adult patients who presented
to our OR suite over two week periods. During the first 15-week period, pa
tients were instructed to drink no liquids after midnight (control group, n
= 2,646). In the second 15-week period, patients were allowed to consume u
nlimited clear fluids until 2 to 3 hours prior to surgery (study group, n =
2,774).
Measurements and Main Results: We found no difference between the control a
nd study groups in the number of cases cancelled (0 in each group) or delay
ed (8 vs. 9; relative risk [RR] = 1.07, 95% confidence interval [CI] = 1.00
0 to 1.148) due to noncompliance with fasting guidelines. There was no diff
erence between the groups,in the number of cases of aspiration (0 in each g
roup). In the control groups, significantly more episodes of regurgitation
were noted (12 vs. 9; RR = 0. 715, 95% Cl = 0.535 to 0.955) and more rapid-
sequence/awake intubations were performed (119 vs. 51; RR = 0.409, 95% Cl =
0.306 to 0.546) than in the study group.
Conclusions: Liberalizing a preoperative fasting policy and allowing patien
ts to consume unrestricted clear fluids up until 3 hours before their sched
uled time of surgery did not affect their compliance with fasting requireme
nts. No increase in cancellations or delays of surgical procedures due to i
nappropriate oral intake was observed. (C) 2000 by Elsevier Science Inc.