Preoperative Fasting Guidelines for Diagnostic Endoscopy

Introduction to Evidence-Based Fasting

• The American Society of Anesthesiologists recommends clear fluids until 2 hours before anesthesia induction and solid food until 6 hours before, as supported by the National and European Anesthesia Societies 1, 2
• Fasting from midnight has never had any scientific evidence supporting it as necessary for reducing aspiration risk, according to the American College of Anesthesiologists 1, 2

Fasting Recommendations

• Clear liquids should be allowed until 2 hours before the procedure, and solid food until 6 hours before, as recommended by the American Society of Anesthesiologists 1, 2
• For a 2 PM procedure, clear liquids should be allowed until 12:00 PM (noon), and solid food until 8:00 AM, based on guidelines from the American Society of Anesthesiologists 1, 2

Special Considerations

• Patients with uncomplicated type 2 diabetes can follow standard fasting guidelines, according to the American Diabetes Association 1, 3
• Morbidly obese patients should follow standard 2-hour clear liquid/6-hour solid food guidelines, as recommended by the American Society of Anesthesiologists 1

Aspiration Risk

• Pulmonary aspiration during procedural sedation is extraordinarily rare and not associated with fasting compliance, as reported by the American Society of Anesthesiologists 6
• The declining incidence of aspiration over recent decades is attributed to improved airway management techniques, not fasting practices, according to the American Society of Anesthesiologists 6