Providers' fasting guidelines for adults

Fasting guidelines apply to people 19 years and older receiving anesthesia from the Department of Anesthesia. This includes general, regional, monitored anesthesia care, and procedural sedation.

The purpose of these guidelines are to:

  • Lower the risk of pulmonary aspiration for people receiving anesthesia services
  • Assist health care providers and patients in knowing when to stop eating and drinking
  • Be a consistent standard of clinical care and evidence-based practice

Guidelines may change for people with:

  • Co-existing conditions such as a difficult airway
  • Conditions that may affect stomach emptying or fluid volume, such as:
    • Diabetes
    • Hiatal hernia
    • Gastro-esophageal reflux disease (GERD)
    • Ileus or bowel obstruction
    • Emergency care

The anesthesia provider will talk with the patient about the needed changes. People with these conditions are at greater risk of aspiration when airway reflexes are compromised by sedative medicines. This may alter anesthetic management.

Minimum fasting should be:

  • 8 hours for enteral feeds or a meal with fried foods, fatty foods, or meat 
  • 6 hours for non-clear fluids 
  • 2 hours for clear fluids
    • Clear fluids are:
      • Water
      • Apple juice or white grape juice (no orange juice)
      • Black coffee or tea (no milk, cream or creamer)
      • Gatorade®
      • Infant electrolyte solutions (Pedialyte®)
      • Carbonated drinks (Coke®, 7-Up®)
Remember: Clear fluids cannot be hazy or cloudy. They cannot have pulp or fats.

Patients may take prescribed medicines with clear liquids before the procedure. Crushed medicines may be given with 2 tablespoons of plain apple jelly.

People should not drink alcohol.

Procedures may be delayed or canceled if people do not follow the guidelines. The amount and type of food or fluid ingested along with the risks and benefits of proceeding will be weighed.

Call the Anesthesia desk at 1-319-356-2724 with questions.

Adapted and liberally paraphrased from practice guidelines by the American Society of Ansthesiologists (© 2017) and the European Society of Anesthesiology (© 2011)
Last reviewed: 
September 2020

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