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For each key question, the evidence synthesis and summary tables of benefits and harms were presented to the task force. 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: An Updated Report by the American Society of Anesthesiologists Task Force on Preoperative Fasting and the Use of Pharmacologic Agents to Reduce the Risk of Gastric volume and pH in infants fed clear liquids and breast milk prior to surgery. No aspiration after carbohydrate-containing clear or noncaloric clear liquids was reported in 17 randomized controlled trials.23,24,26,39,55,57,59,63,74,75,77,78,8084 (strength of evidence not rated due to lack of events). The mean age was 53.1 yr (range, 26 to 81), and 61% were women. No search for unpublished studies was conducted, and no reliability tests for locating research results were done. 15 to 16, https://links.lww.com/ALN/C935) and thirst2342 compared with fasting patients (moderate strength of evidence). Safety and efficacy of oral rehydration therapy until 2h before surgery: a multicenter randomized controlled trial. Statistically significant (P< 0.01) outcomes are designated as either beneficial (B) or harmful (H) for the patient; statistically nonsignificant findings are designated as equivocal (E). Going from evidence to recommendationsThe significance and presentation of recommendations. Eight hours fasting from enteral feeds is preferred. These guidelines do not address the use of antiemetics during the extended postoperative period after upper airway protective reflexes are no longer impaired. 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: An Updated Report by the American Society of Anesthesiologists Task Force on Preoperative Fasting and the Use of Pharmacologic Agents to Reduce the Risk of Pulmonary Aspiration. Procedures in which upper airway protective reflexes may be impaired. Effects of preoperative fasting abbreviation with carbohydrate and protein solution on postoperative symptoms of gynecological surgeries: Double-blind randomized controlled clinical trial. Preoperative fasting of 2 hours minimizes insulin resistance and organic response to trauma after video-cholecystectomy: A randomized, controlled, clinical trial. Use of ultrasound for gastric volume evaluation after ingestion of different volumes of isotonic solution. A summary of recommendations is found in appendix 1 (table 1). Supplemental Digital Content is available for this article. Recommendations based on the CORESTA Technical Report Aspiration pneumonitis and aspiration pneumonia. Effects of preoperative oral carbohydrates on patients undergoing esd surgery under general anesthesia: A randomized control study. These studies were combined with 133 pre-2010 articles used in the previous update, resulting in a total of 175 articles found acceptable as evidence for these guidelines. Category C: Informal Opinion. Gastric emptying after overnight fasting and clear fluid intake: A prospective investigation using serial magnetic resonance imaging in healthy children. A complete bibliography of articles used to develop these updated guidelines, organized by section, is available as Supplemental Digital Content 2, http://links.lww.com/ALN/B348. The literature relating to seven evidence linkages contained enough studies with well-defined experimental designs and statistical information to conduct formal meta-analyses. The evidence comparing fasting with protein-containing clear liquids in adults was limited to single trials for each patient-reported outcome (table 4). Michigan Right To Farm Act Backyard Chickens, Articles A

In this issue, we will talk about some important skills needed for office par...