Fasting and Aspiration Risk

​The following durations are the current ANZCA recommendations for MINIMUM fasting times prior to anaesthesia. THese guidelines are applicable to many patients, but special consideration should be given to patients on medication that delay gastric emptying, or those who have pathology or previous surgery that may alter gastric emptying. Note that non-clear fluids (eg tea/coffee with milk, fruit juice that contains pulp) is considered to be a solid

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• Adults (16+ years old):

  • Solids: light (low calorific) meal more than 6hrs prior to anaesthesia

  • Clear liquids: more than 2hrs prior to anaesthesia. The accepted rate at which clear fluid can be consumed is up to 170ml/hr, or 400ml at the 2hr mark prior to anaesthesia - but only in patients having suitable non-gastrointestinal, non-trauma related surgery

  • 'Sip til send' is increasingly gaining acceptance. This practice allows the patient to sip clear fluids only (usually water) until they are sent for

  • Sips of water (up to 30ml for an adult) are acceptable up until the time of surgery to aid swallowing medications​

• Children between 12 months and 16 years of age

  • Solids: light (low calorific) meal up to 6hrs prior to anaesthesia​​

  • Clear liquids: 3ml/kg/hr up to 1hr prior to anaesthesia​

  • Breast milk: up to 3hrs prior to anaesthesia

  • Formula and non-human milk: considered as solids, so are only acceptable up to 6hrs prior to anaesthesia

• Infants from birth to 12months of age

  • Breast milk: Up to 3hrs prior to anaesthesia​

  • Formula and non-human milk: 200ml or 20ml/kg (whichever is least) up to 4hrs prior to anaesthesia

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Chewing gum and boiled sweets are regarded as a potential foriegn body, so must be discarded prior to anaesthesia - but are NOT an indication for delaying a procedure unless ingested​

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Patients on GLP-1 agonists (eg Ozempic)

• ANZCA guidance (see this link) has been issued in early 2025, stating that these medications should not be ceased peri-operatively

• These patients should consume only clear fluids for 24hrs prior to anaesthesia, followed by the standard 6hr fasting

• If patients have not undergone this pre-procedure clear fluid diet then risk mitigation strategies should be employed. This flowchart is copied from appendix 1 in this ANZCA document, and is pasted here for convenience.

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