The effect of a new NPO policy on operating room utilization

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.