Anaesthetists Scorn 'Nil by Mouth' Pre-Operative Guidelines

Patients fasting before surgery may be doing themselves harm, according to a presentation held at the Australian and New Zealand College of Anaesthetists (ANZCA) meeting over the weekend.

Dr David Rowe, an anaesthetist from Armidale in NSW and a fellow of ANZCA, said the practice of restricting solids and liquids before anaesthesia needs to be revisited so patients can keep up their strength before any procedure that involves an anaesthetic.

The current ‘nil by mouth’ guidelines sends the patient’s body into a starved state, forcing the breakdown of muscle and fat which is much needed for post-operation recovery.

“If you are about to run a marathon you wouldn’t have a light meal the night before and then skip breakfast - major surgery compares to running a marathon in terms of the pressure on the body.”

He said patients reported less hunger, thirst, headache and nausea on arrival in operating theatres when allowed nutrients in the form of clear, carbohydrate-rich fluids two hours before anaesthesia.

“Let’s not starve patients excessively – carbohydrate drinks taken two hours pre-operatively make the anaesthetic safer and will improve recovery as well as make the patient’s experience more pleasant.”