Best Practice & Research Clinical Anaesthesiology
Volume 20, Issue 3 , Pages 363-378 , September 2006

Fasting from midnight – the history behind the dogma

  • J. Roger Maltby, MB, FRCA, FRCPC (Professor Emeritus of Anaesthesia, University of Calgary)

      Affiliations

    • Corresponding Author InformationTel.: +1 403 242 6328; Fax: +1 403 242 4836.

References 

  1. Robinson J. A Treatise on the Inhalation of the Vapour of Ether. London: Webster; 1847;
  2. Snow J. On the Inhalation of the Vapour of Ether in Surgical Operations. London: John Churchill; 1847;p. 28
  3. Snow J. On Chloroform and Other Anaesthetics: Their Action and Administration. London: John Churchill; 1858;pp. 74–75
  4. Balfour GW. New cause of death by chloroform. Edinburgh Medical Journal. 1862;8:194–195
  5. Lister J. On anaesthetics. In: Holmes System of Surgery. 3rd edn. London: Longmans Green and Co.; 1883;
  6. Lyman HM. Artificial Anaesthesia and Anaesthetics. New York: Wood; 1881;p. 287
  7. Hewitt FW. The Administration of Nitrous Oxide and Oxygen for Dental Operations. 4th edn. London: Claudius Ash, sons & Co., Limited; 1911;pp. 36–37
  8. Gwathmey JT. Anesthesia. New York: D Appleton and Company; 1914;pp. 365–366
  9. Buxton DW. Anaesthetics: Their uses and Administration. 6th edn. London: HK Lewis; 1920;pp. 424–425
  10. Woodbridge PD. Preanesthetic breakfast. Anesthesiology. 1943;4:81
  11. Macintosh RR, Bannister FB. Essentials of General Anaesthesia. 4th edn. Oxford: Blackwell Scientific Publications Ltd; 1947;pp. 135–136
  12. Lee JA. A Synopsis of Anaesthesia. Bristol: John Wright & Sons Ltd.; 1947;p. 19
  13. Minnitt RJ, Gillies J. Textbook of Anaesthetics. 7th edn. Edinburgh: E & S Livingstone; 1948;pp. 70–71
  14. Hunt AM. Anesthesia Principles and Practice. New York: GP Putnam's Sons; 1949;p. 33
  15. Guedel AE. Inhalation Anesthesia. 2nd edn. New York: Macmillan; 1951;pp. 89–101
  16. Eliason EL, Ferguson LK, Sholtis LA. Surgical Nursing. 10th edn. Philadelphia: JB Lippincott Company; 1955;pp. 56–57
  17. Lee JA & Atkinson RS. A Synopsis of Anaesthesia. 5th edn. John Wright & Sons Ltd., p. 64.
  18. Cohen DD, Dillon GB. Anesthesia for Outpatient Surgery. Springfield: CC Thomas; 1970;pp. 11–12
  19. Wylie WD, Churchill-Davidson HC. A Practice of Anaesthesia. 5th edn. Chicago: Year Book Publishers Inc.; 1972;pp. 1298–1317
  20. Guidelines for Basic Standards of Practice of Anaesthesia. Toronto: The Canadian Anaesthetists' Society Inc.; 1981;p. 6
  21. Collins VJ. Principles of Anesthesiology. 2nd edn. Philadelphia: Lea & Febiger; 1976;pp. 190–191
  22. Dripps RD, Eckenhoff JE, Vandam LD. Introduction to Anaesthesia. Philadelphia: WB Saunders Company; 1961;p. 5
  23. Ong BY, Palahniuk RJ, Cumming M. Gastric volume and pH in out-patients. Canadian Anaesthetists' Society Journal. 1978;25:36–39
  24. Sutherland AD, Stock JG, Davies JM. Effects of preoperative fasting on morbidity and gastric contents in patients undergoing day-stay surgery. British Journal of Anaesthesia. 1986;58:876–878
  25. Maltby JR, Sutherland AD, Sale GP, Shaffer EA. Preoperative oral fluids: Is a five-hour fast justified prior to elective surgery?. Anesthesia and Analgesia. 1986;65:1112–1116
  26. Mendelson CL. The aspiration of stomach contents into the lungs during obstetric anesthesia. American Journal of Obstetrics and Gynecology. 1946;52:191–205
  27. Morton HJV, Wylie WD. Anaesthetic deaths due to regurgitation. Anaesthesia. 1951;6:190–201, 205
  28. Inkster JS. The induction of anaesthesia in patients likely to vomit with special reference to intestinal obstruction. British Journal of Anaesthesia. 1963;35:160–167
  29. Wylie WD. The use of muscle relaxants at the induction of anaesthesia of patients with a full stomach. British Journal of Anaesthesia. 1963;35:168–173
  30. Snow RG, Nunn JF. Induction of anaesthesia in the foot-down position for patients with a full stomach. British Journal of Anaesthesia. 1959;31:493–497
  31. Sellick BA. Cricoid pressure to control regurgitation of stomach contents during induction of anaesthesia. Lancet. 1961;2:404–406
  32. Dinnick OP. Deaths associated with anaesthesia. Observations on 600 cases. Anaesthesia. 1964;19:536–556
  33. Roberts RB, Shirley MA. Reducing the risk of gastric aspiration during cesarean section. Anesthesia and Analgesia. 1974;53:859–868
  34. Roberts RB, Shirley MA. Antacid therapy in obstetrics. Anesthesiology. 1980;83:53
  35. Raidoo DM, Rocke DA, Brock-Utne JG, et al. Critical volume for pulmonary acid aspiration: reappraisal in a primate model. British Journal of Anaesthesia. 1990;65:248–250
  36. Stoelting RK. Responses to atropine, glycopyrrolate, and riopan of gastric fluid pH and volume in adult patients. Anesthesiology. 1978;48:367–369
  37. Salmenpera M, Kortilla K, Kalima T. Reduction of the risk of acid pulmonary aspiration in anaesthetized patients after cimetidine premedication. Acta Anaesthesiologica Scandinavica. 1980;24:25–30
  38. Hester JB, Heath ML. Pulmonary acid aspiration syndrome. Should prophylaxis be routine?. British Journal of Anaesthesia. 1977;49:595–599
  39. Miller M, Wishart HY, Nimmo WS. Gastric contents at induction of anaesthesia. Is a 4-hour fast necessary?. British Journal of Anaesthesia. 1983;55:1185–1188
  40. Strunin L. The Liver and Anaesthesia. New York: WB Saunders Company; 1977;
  41. Beaumont W. Experiments and Observations on the Gastric Juice and the Physiology of Digestion. Plattsburgh: Allen; 1833;
  42. Roland CG. Alexis St. Martin and his relationship with William Beaumont. Annals of the Royal College of Physicians and Surgeons of Canada. 1988;21:15–20
  43. Lovell J. A case of wounded stomach. American Medical Recorder. 1825;8:14–19
  44. Osler W. William Beaumont a backwood physiologist. The Journal of the American Medical Association. 1902;39:1223–1231
  45. Minami H, McCallum RW. The physiology and pathophysiology of gastric emptying in humans. Gastroenterology. 1984;86:1592–1610
  46. Hunt JN. Some properties of an elementary osmoreceptor mechanism. The Journal of Physiology. 1956;132:267–288
  47. Horowitz M, Pounder DJ. Is the stomach a useful forensic clock. Australian and New Zealand Journal of Medicine. 1985;15:273–276
  48. Hinder RA, Kelly KA. Canine gastric emptying of solids and liquids. The American Journal of Physiology. 1977;133:E335–E340
  49. Guyton AC. Textbook of Medical Physiology. 6th edn. Philadelphia: WB Saunders Company; 1981;p. 440
  50. Guyton AC. Textbook of Medical Physiology. 6th edn. Philadelphia: WB Saunders Company; 1981;pp. 791–792
  51. O'Mullane EJ. Vomiting and regurgitation during anaesthesia. Lancet. 1954;1:1209–1212
  52. Goudsouzian NG, Karamanian A. Physiology for the Anesthesiologist. New York: Appleton-Century-Crofts; 1977;
  53. Department of Health and Social Security . Report on confidential inquiries into maternal death 1976–1978. London: Her Majesty's Stationery Office; 1982;pp. 77–88
  54. Harrison GG. Death attributable to anaesthesia. A 10-year survey (1967–1976). British Journal of Anaesthesia. 1978;50:1041–1048
  55. Sutherland AD, Maltby JR, Sale JP, Reid CRG. The effect of preoperative oral fluid and ranitidine on gastric fluid volume and pH. Canadian Journal of Anaesthesia. 1987;34:117–121
  56. Hutchinson A, Maltby JR, Reid CRG. Gastric fluid volume and pH in elective inpatients. Part 1: coffee or orange juice versus overnight fast. Canadian Journal of Anaesthesia. 1988;35:12–15
  57. McGrady EM, Macdonald AG. Effect of the preoperative administration of water on gastric volume and pH. British Journal of Anaesthesia. 1988;60:803–805
  58. Agarwal A, Chari P, Singh H. Fluid deprivation before operation. The effect of a small drink. Anaesthesia. 1989;44:632–634
  59. Scarr M, Maltby JR, Jani K, Sutherland LR. Volume and acidity of residual gastric fluid after oral fluid ingestion before elective ambulatory surgery. Canadian Medical Association Journal. 1989;141:1151–1154
  60. Read MS, Vaughan RS. Allowing pre-operative patients to drink: effects on patients' safety and comfort of unlimited oral water until 2 hours before anaesthesia. Acta Anaesthesiologica Scandinavica. 1991;35:591–595
  61. Maltby JR, Lewis P, Martin A, Sutherland LR. Gastric fluid volume and pH in elective patients following unrestricted oral fluid until three hours before surgery. Canadian Journal of Anaesthesia. 1991;38:425–429
  62. Mahiou P, Narchi P, Gory G, et al. Is coloscopic preparation with oral polyethylene glycol 2 hours before general anesthesia safe in ambulatory patients?. Anesthesiology. 1991;75:A1108
  63. Lam KK, So KK, Gin T. Gastric pH and volume after oral fluids in the postpartum patient. Canadian Journal of Anaesthesia. 1993;40:218–221
  64. Phillips S, Hutchinson S, Davidson T. Preoperative drinking does not affect gastric contents. British Journal of Anaesthesia. 1993;70:6–9
  65. Søreide E, Holst-Larsen H, Reite K, et al. The effects of giving 25–450 ml of water with diazepam premedication 1–2 hours before general anaesthesia. British Journal of Anaesthesia. 1993;71:503–506
  66. Maltby JR, Hutchinson A, Reid CRG. Gastric fluid volume and pH in elective inpatients. Part 2: Coffee or orange juice with ranitidine. Canadian Journal of Anaesthesia. 1988;35:16–19
  67. Søreide E, Strømskag KE, Steen PA. Statistical aspects in studies of preoperative fluid intake and gastric content. Acta Anaesthesiologica Scandinavica. 1995;39:738–743
  68. Crawford JS. Preoperative oral fluids. Anesthesia and Analgesia. 1987;66:914–915
  69. Plourde G, Hardy JF. Aspiration pneumonia: assessing the risk of regurgitation in the cat. Canadian Anaesthetists' Society Journal. 1986;33:345–348
  70. Olsson GL, Hallen B, Hambraeus-Jonzon K. Aspiration during anaesthesia: a computer-aided study of 185,358 anaesthetics. Acta Anaesthesiologica Scandinavica. 1986;30:84–92
  71. Tiret L, Nivoche Y, Hatton F, et al. Complications related to anaesthesia in infants and children: a prospective survey of 40240 anaesthetics. British Journal of Anaesthesia. 1988;61:263–269
  72. Pandit SK, Loberg KW, Pandit UA. Toast and tea before elective surgery? A national survey on current practice. Anesthesia and Analgesia. 2000;90:1348–1351
  73. Taylor WJ, Champion MC, Barry AW, Hurtig JB. Measuring gastric contents during general anaesthesia: evaluation of blind aspiration. Canadian Journal of Anaesthesia. 1989;36:51–54
  74. Hardy JF, Plourde G, Lebrun M, et al. Determining gastric contents during general anaesthesia: evaluation of two methods. Canadian Journal of Anaesthesia. 1987;34:474–477
  75. Maltby JR, Shaffer EA. Measurement of gastric contents. Canadian Journal of Anaesthesia. 1990;37:597–598
  76. Coté CJ. NPO after midnight in children – a reappraisal. Anesthesiology. 1990;72:589–592
  77. Sandhar BK, Goresky GV, Maltby JR, Shaffer EA. Effect of oral liquids and ranitidine on gastric fluid volume and pH in children undergoing outpatient surgery. Anesthesiology. 1989;71:327–330
  78. Schreiner MS, Triebwasser A, Keon TP. Ingestion of liquids compared with preoperative fasting in pediatric outpatients. Anesthesiology. 1990;72:593–597
  79. Splinter WM, Schaefer JD, Zunder IH. Clear fluids three hours before surgery do not affect the gastric fluid contents of children. Canadian Journal of Anaesthesia. 1990;37:498–501
  80. Goresky GV, Maltby JR. Fasting guidelines for elective surgical patients. Canadian Journal of Anaesthesia. 1990;37:493–495
  81. Hardy JF. Preoperative fasting: in medio stat virtus. Canadian Journal of Anaesthesia. 1991;38:256–257
  82. Stoelting RK. The 29th Rovenstine lecture: clinical challenges for the anesthesiologist. Anesthesiology. 1991;74:1129–1136
  83. Stoelting RK. NPO and Aspiration Pneumonitis. 46th Annual Refresher Course Lectures and Clinical Update Program. Park Ridge: American Society of Anesthesiologists Inc.; 1995;p. 432
  84. Strunin L. How long should patients fast before surgery. Time for new guidelines. British Journal of Anaesthesia. 1993;70:1–3
  85. Warner MA, Warner ME, Weber JG. Clinical significance of pulmonary aspiration during the perioperative period. Anesthesiology. 1993;78:56–62
  86. Nicolson SC, Schreiner MS. Feed the babies. Anesthesia and Analgesia. 1994;79:407–409
  87. Lichtor JL. Psychological Preparation and Preoperative Medication. In:  Miller RD editors. 3rd edn. New York: Churchill Livingstone; 1990;p. 895–928
  88. Wetchler BV. Anesthesia for Ambulatory Surgery. 2nd edn. Philadelphia: JB Lippincott; 1991;pp. 593–625
  89. Søreide E, Fasting S, Raeder JC. New preoperative fasting guidelines in Norway. Acta Anaesthesiologica Scandinavica. 1997;41:799
  90. Fasting S, Søreide E, Raeder JC. Changing preoperative fasting policies. Impact of a national consensus. Acta Anaesthesiologica Scandinavica. 1998;42:1188–1191
  91. American Society of Anaesthesiologists Task Force on Preoperative Fasting . Practice guidelines for preoperative fasting and the use of pharmacologic agents to reduce the risk of pulmonary aspiration: application to healthy patients undergoing elective procedures: a report by the American Society of Anaesthesiologists Task Force on Preoperative Fasting. Anesthesiology. 1999;90:896–905

PII: S1521-6896(06)00018-8

doi: 10.1016/j.bpa.2006.02.001

Best Practice & Research Clinical Anaesthesiology
Volume 20, Issue 3 , Pages 363-378 , September 2006

Article Tools