The necessity of 2-hour pre-operative fasting for patients

Abstract

Aim: The paper discusses the findings of an audit carried out at Manchester Royal Eye Hospital. Its focus was to explore whether it was necessary for patients to fast 2 hours prior to undergoing surgery (including vitreoretinal) under local anaesthetic.A total of 67 patients were included in the audit (27 female (40%), 40 male (60%)}. Results: Average age was 68 years (range 31-98 years). 60/67 had sub-Tenon's local anaesthetic (90%), 5/67 (7.5%) had peribulbar anaesthetic and 2/67 (3%) had topical anaesthetic. Results show that over an 8 month window of prospective audit on vitreoretinal patients who had undergone surgery for a variety of indications and with different diagnoses typical of a tertiary vitreoretinal service, both by retinal fellows and consultants, with a time on average of over an hour per case, there were no reported clinical incidences 0/67 (0%) that were either caused by a lack of fasting, or exacerbated by a lack of fasting. Discussion: As a result of this audit we recommended that for all patients undergoing local anaesthetic (excluding sedation) vitreoretinal procedures, and because cataract surgery is usually of a significantly shorter duration, fasting for 2 hours is unnecessary. The standard for best practice policy is now embedded in practice within the ophthalmic division in Central Manchester Foundation Trust.