Søreide E, Eriksson L I, Hirlekar G, Eriksson H, Henneberg S W, Sandin R, Raeder J
Department of Anaesthesia and Intensive Care, Stavanger University Hospital, Stavanger, Norway.
Acta Anaesthesiol Scand. 2005 Sep;49(8):1041-7. doi: 10.1111/j.1399-6576.2005.00781.x.
Liberal pre-operative fasting routines have been implemented in most countries. In general, clear fluids are allowed up to 2 h before anaesthesia, and light meals up to 6 h. The same recommendations apply for children and pregnant women not in labour. In children <6 months, most recommendations now allow breast- or formula milk feeding up to 4 h before anaesthesia. Recently, the concept of pre-operative oral nutrition using a special carbohydrate-rich beverage has also gained support and been shown not to increase gastric fluid volume or acidity. Based on the available literature, our Task Force has produced new consensus-based Scandinavian guidelines for pre-operative fasting. What is still not clear is to what extent the new liberal fasting routines should apply to patients with functional dyspepsia or systematic diseases such as diabetes mellitus. Other still controversial areas include the need for and effect of fasting in emergency patients, women in labour and in association with procedures done under 'deep sedation'. We think more research on the effect of various fasting regimes in subpopulations of patients is needed before we can move one step further towards completely evidence-based pre-operative fasting guidelines.
大多数国家都采用了较为宽松的术前禁食常规。一般来说，麻醉前2小时可饮用清液，6小时前可进食清淡食物。同样的建议适用于非分娩期的儿童和孕妇。对于6个月以下的儿童，目前大多数建议允许在麻醉前4小时进行母乳喂养或配方奶喂养。最近，使用特殊富含碳水化合物饮料进行术前口服营养的概念也得到了支持，并且已证明不会增加胃液量或酸度。根据现有文献，我们的特别工作组制定了基于新共识的斯堪的纳维亚术前禁食指南。目前尚不清楚的是，新的宽松禁食常规应在多大程度上适用于功能性消化不良患者或糖尿病等系统性疾病患者。其他仍有争议的领域包括急诊患者、分娩期妇女以及与“深度镇静”下进行的手术相关的禁食需求和效果。我们认为，在我们能够朝着完全基于证据的术前禁食指南再迈进一步之前，需要对不同禁食方案在患者亚群中的效果进行更多研究。
