Stuart Pauline C
Department of Anaesthesia, Glasgow Royal Infirmary, 84 Castle Street Glasgow G4 OSF, UK.
Best Pract Res Clin Anaesthesiol. 2006 Sep;20(3):457-69. doi: 10.1016/j.bpa.2006.03.001.
Fasting before general anaesthesia aims to reduce the volume and acidity of stomach contents, thus decreasing the risk of regurgitation/aspiration. The objectives of the Cochrane report which are summarised in this paper, were to systematically review the effect of different preoperative fasting regimes (duration, type and volume of intake) on perioperative complications and patient wellbeing. Few trials reported the incidence of aspiration/regurgitation or related morbidity but relied on indirect measures of patient safety ie. intraoperative gastric volume and pH. There was no evidence to suggest intake of fluids up to 2 hr preoperatively has an impact on patients gastric volumes or pH. Intake of fluids up to 90 min preoperatively had no impact on gastric contents but this was based on small numbers. In addition, permitting patients to drink water preoperatively resulted in significantly lower gastric volumes. Clinicians should evaluate this evidence for themselves and when necessary, adjust existing fasting policies.
全身麻醉前禁食旨在减少胃内容物的量和酸度，从而降低反流/误吸的风险。本文总结的Cochrane报告的目的是系统评价不同术前禁食方案（持续时间、摄入类型和量）对围手术期并发症和患者健康状况的影响。很少有试验报告误吸/反流的发生率或相关发病率，而是依赖于患者安全的间接指标，即术中胃内容量和pH值。没有证据表明术前2小时内摄入液体对患者胃容量或pH值有影响。术前90分钟内摄入液体对胃内容物没有影响，但这是基于少量样本。此外，允许患者术前饮水可显著降低胃容量。临床医生应自行评估这一证据，并在必要时调整现有的禁食政策。
