Schumacher A, Vagts D A, Nöldge-Schomburg G F E
Klinik und Poliklinik für Anästhesiologie und Intensivtherapie, Universität Rostock.
Anaesthesiol Reanim. 2003;28(4):88-96.
Over the last years several clinical studies have modified the guidelines for preoperative fasting to reduce the risk of pulmonary aspiration. In most western countries the following guidelines are accepted: for clear liquids 2 hours, breast feeding 4 hours, small meals and breast milk substitutes 6 hours, heavy meals 8 hours. Since preoperative smoking is acknowledged as a risk factor, it should be ceased in most clinics 6 hours before induction of anaesthesia, as well. Smoking, however, does not increase the risk of pulmonary aspiration, as is often maintained, but increases the risk of postoperative pulmonary complications. To reduce the risk of perioperative pulmonary complications, cessation of smoking is necessary 8 weeks before operation. Stopping smoking only a few days before operation and anaesthesia even tends to increase the risk of pulmonary complications. Regarding cardiac complications, cessation of smoking 12 hours before anaesthesia is sufficient to reduce the incidence of cardiac ischaemia.
在过去几年中，多项临床研究对术前禁食指南进行了修订，以降低肺误吸风险。在大多数西方国家，以下指南被广泛接受：清亮液体禁食2小时，母乳喂养禁食4小时，少量餐食和母乳替代品禁食6小时，大量餐食禁食8小时。由于术前吸烟被认为是一个风险因素，大多数诊所也应在麻醉诱导前6小时停止吸烟。然而，吸烟并不会像人们通常认为的那样增加肺误吸风险，而是会增加术后肺部并发症的风险。为降低围手术期肺部并发症的风险，术前8周必须戒烟。仅在手术和麻醉前几天才戒烟甚至可能会增加肺部并发症的风险。关于心脏并发症，麻醉前12小时戒烟足以降低心肌缺血的发生率。
