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Review: evidence is lacking to show that adults given fluids 1.5–3 hours preoperatively have greater risks of aspiration or regurgitation than those given a standard fast
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 Q In adults, what are the effects of different preoperative fasting regimens (duration, type, and volume of permitted intake) on perioperative complications and patient wellbeing?

Clinical impact ratings Internal medicine ★★★★★☆☆ Anaesthaesia ★★★★★☆☆ Surgery ★★★★★★☆

METHODS

Embedded ImageData sources:

Medline (1966 to August 2003), CINAHL (1982 to August 2003), the Cochrane Central Register of Controlled Trials (second quarter, 2003), and the UK National Research Register (August 2003); bibliographies of relevant studies and conference proceedings; and experts.

Embedded ImageStudy selection and assessment:

randomised controlled trials (RCTs) or quasi-RCTs that compared the effects of different preoperative fasting regimens prior to general anaesthesia; included adults ⩾18 years of age; and reported postoperative complications. A standard fast was defined as nothing by mouth from midnight before morning surgery or a small breakfast early in the morning before afternoon surgery; intake of …

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