Volume 29, Issue 160, June 2025

Revisiting Preoperative Fasting: Benefits and Safety of Shortened Clear Fluid Restrictions Before Elective Surgery

Dominik Tomczak^1♦, Justyna Kuciel¹, Kinga Świtała², Maria Mroczka², Roksana Hrapkowicz³, Kinga Erazmus³, Agnieszka Czernecka⁴, Karolina Jałocha⁵, Marek Borecki⁵, Patrycja Pysz²

¹Chrzanów District Hospital, Topolowa 16, 32-500 Chrzanów, Poland
²V Military Hospital with Polyclinic, Wrocławska 1-3, 30-901 Kraków, Poland
³Ludwik Rydygier Specialist Hospital, Os. Złotej Jesieni 1, 31-820 Kraków, Poland
⁴Hospital of the Ministry of Internal Affairs and Administration, Kronikarza Galla 25, 30-053 Kraków, Poland
⁵Karol Marcinkowski University Hospital, Zyty 26, 65-046 Zielona Góra, Poland

^♦Corresponding author
Dominik Tomczak, Chrzanów District Hospital, Topolowa 16, 32-500 Chrzanów, Poland

ABSTRACT

Before Elective surgery, it is often required to restrict food intake before the procedure, with clear fluids typically allowed up to two hours before anesthesia induction. Recent studies have shown that this extended fasting period may lead to discomfort and complications such as dehydration, electrolyte imbalance, reduced patient satisfaction, increased risk of postoperative nausea and vomiting (PONV), and increased stress on the body. Protocols describing shorter periods of fluid consumption abstinence have been getting attention as potentially safer and more comfortable alternatives, with growing evidence that suggests the potential benefits for patients. This review aims to synthesize findings from various randomized controlled trials, meta-analyses, and observational studies to assess the benefits, risks, and potential applications of reduced preoperative fasting. The benefits of reduced fasting times, including improved hydration, decreased patient anxiety, and enhanced postoperative recovery, will be discussed. Additionally, this paper will assess safety concerns, including the risk of aspiration during intubation and the potential for delayed gastric emptying in certain individuals. The paper will analyze the efficacy of shortened fasting protocols in various specialties, with an emphasis on gastrointestinal and anesthesiology outcomes. The findings suggest that, with guidelines and careful management, a shortened fluid intake abstinence period can produce outcomes that would reduce perioperative discomfort without compromising any of the patient's safety.

Keywords: fasting, preoperative fasting, ERAS, fluid intake

Medical Science, 2025, 29, e91ms3576

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DOI: https://doi.org/10.54905/disssi.v29i160.e91ms3576

Published: 25 June 2025