FASTING GUIDELINES IN PREOPERATIVE .pptx

This ppt contains the detailed information on fasting guidelines in adults, pediatrics, obesity and pregnancy

1. Fasting Guidelines and Premedication in Anesthesia By Dr. Vipul Jaiswal Wockhardt Hospital

2. IMPORTANCE OF FASTING Prevents aspiration of gastric contents during anesthesia. Reduces the risk of complications like pneumonia and respiratory distress Ensures patient safety and successful surgical outcomes.

3. OBJECTIVES OF THE PRESENTATION To review current fasting guidelines for different types of food and beverages. To discuss the rationale behind fasting recommendations. To explore the role of premedication in anesthesia. To identify potential complications and their management.

4. The modern practice of fasting prior to an operation began with Dr. Curtis Mendelson’s Observation in 1946 He reported that patients who has ingested food shortly before the surgical procedure were more likely to regurgitate their stomach contents with severe consenquences ( aspiration pneumonia )

5. FASTING GUIDELINES General Principles : Based on the type of food and time to surgery Aim to minimize the volume and acidity of gastric contents. Individualized based on patient factors (age, health status, etc.).

6. ASA 2020 GUIDELINES

7. Rationale for Fasting • Gastric Emptying: - Time required for the stomach to empty its contents.Varies depending on the type and volume of food consumed. Clear liquids empty the fastest, followed by breast milk, formula, and solid foods. • Gastric Acidity:- Fasting helps reduce gastric acid production. Medications like proton pump inhibitors (PPIs) and H2 receptor antagonists may be used to further reduce acidity.

8. SOLIDS It requires more time than liquid to be emptied from the Stomach Why ?

9. FASTING GUIDELINES IN PEDIATRIC PATIENTS

10. FASTING GUIDELINES IN DIABETIES People with diabeties requires prolonged fasting time when compared with the non- diabetic

11. FASTING GUIDELINES IN OBESITY AND PREGNANCY Obese individuals often require longer NPO (nothing by mouth) times before surgery or procedures due to factors like increased gastric volume and a higher risk of aspiration, which can be exacerbated by abdominal obesity and its impact on gastric pressure.

12. Obesity is associated with increased residual gastric volume (>25 mL despite 8 hours NPO) and low gastric fluid pH (<2.5) compared to non-obese individuals. Abdominal obesity increases intragastric pressure, increasing risk of GERD and/or hiatal hernia formation, both of which increase the risk of aspiration.

13. COMPLICATIONS OF NPO