We'd like to clarify the information on preoperative fasting in your recent article, "Preventing Perioperative Complications in Special Populations" (November 2005). Guidelines published by the American Society of Anesthesiologists (ASA) in 1999 recommend these minimum preoperative fasting times:
* 2 hours for clear liquids
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* 4 hours for breast milk
* 6 hours for formula, nonhuman milk, or a light meal (such as tea and toast)
* 8 hours for a regular meal.
An easy way to remember these times is "2-4-6-8."
The ASA stresses that these are guidelines, not standards or mandates. The guidelines may need to be modified for patients with conditions that may alter gastric emptying or that make airway management difficult.
JEANNETTE CRENSHAW, RN, IBCLC, LCCE, MSN
ELIZABETH H. WINSLOW, RN, PHD, FAAN
Practice guidelines for preoperative fasting and the use of pharmacologic agents to reduce the risk of pulmonary aspiration: Application to healthy patients undergoing elective procedures: A Report by the American Society of Anesthesiologists Task Force on Preoperative Fasting. Anesthesiology. 90(3):896-903, March 1999.