(The authors reply)
We appreciate Dr. Maltby's comments regarding the Evidence Based Reviews in Surgery (EBRS) article on preoperative fasting published in the October 2005 issue of the Canadian Journal of Surgery. We are pleased that Dr. Maltby agrees with the evidence provided and supports a policy of fasting of 6 hours for easily digested solids and 2 hours for clear liquids in patients who undergo elective operative therapy. Dr. Maltby questioned the phrase “classical surgical and anesthesia dictum has been that patients … should be kept NPO from midnight the night before operation.” We would agree completely with his contention that guidelines should be evidence-based, and the best evidence suggests that policy is unnecessary. It must be pointed out, however, that at many hospitals this “classical” dictum persists. One of the aims of EBRS is to provide the current best evidence on a topic, hopefully resulting in a change in clinical practice. Thus, we thank Dr. Maltby for his comments and concur completely with his recommendations.
Competing interests: None declared.