Pre‐operative fasting: a nationwide survey of German anaesthesia departments

Background: Shorter pre‐operative fasting improves clinical outcome without an increased risk. Since October 2004, German Anaesthesiology Societies have officially recommended a fast of 2 h for clear fluids and 6 h for solid food before elective surgery. We conducted a nationwide survey to evaluate the current clinical practice in Germany. Methods: Between July 2006 and January 2007, standardized questionnaires were mailed to 3751 Anaesthesiology Society members in leading positions requesting anonymous response. Results: The overall response rate was 66% (n=2418). Of those, 2148 (92%) claimed familiarity with the new guidelines. About a third (n=806, 34%) reported full adherence to the new recommendations, whereas 1043 (45%) reported an eased fasting practice. Traditional Nil per os after midnight was still recommended by 157 (7%). Commonest reasons reported for adopting the new guidelines were: ‘improved pre‐operative comfort’ (84%), and ‘increased patient satisfaction’ (83%); reasons against were: ‘low flexibility in operation room management’ (19%), and ‘increased risk of aspiration’ (13%). Conclusion: Despite the apparent understanding of the benefits from reduced pre‐operative fasting, full implementation of the guidelines remains poor in German anaesthesiology departments.