Editorials

Drinking before sedation

BMJ 1997; 314 doi: https://doi.org/10.1136/bmj.314.7075.162 (Published 18 January 1997) Cite this as: BMJ 1997;314:162

Preoperative fasting should be the exception rather than the rule

  1. S M Greenfield, Consultant gastroenterologista,
  2. G J M Webster, Specialist registrarb,
  3. F R Vicary, Consultant physicianc
  1. a Department of Gastroenterology, Queen Elizabeth II Hospital, Welwyn Garden City, Hertfordshire AL7 4HQ
  2. b Department of Medicine, Royal Free Hospital School of Medicine, London NW3 2PF
  3. c Department of Gastroenterology, Whittington Hospital, London N19 5SF

    Traditionally, patients are starved of food and fluid for several hours before being given a general anaesthetic. However, in the early days of anaesthesia a drink was often recommended before the procedure,1 and a fluid fast became commonplace only after the publication of Mendelson's landmark study in 1946.2 In it he described the risk of gastric acid aspiration during obstetric anaesthesia with the consequent development of pneumonitis. He also showed that human gastric acid injected into the airway of rabbits caused radiographic changes similar to those described after acid aspiration in pregnant women.

    The findings of these studies have since been extrapolated to all forms of general anaesthesia, resulting in patients being deprived of fluid from midnight before a morning anaesthetic and allowed only a light breakfast before afternoon surgery. Furthermore, …

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