• J-P Breuer, G Bosse, S Seifert, L Prochnow, J Martin, A Schleppers, G Geldner, E Soreide, and C Spies.
• Department of Anaesthesiology and Intensive Care Medicine, Campus Charité Mitte und Campus Virchow-Klinikum, CHARITE- Universitätsmedizin Berlin, 10117 Berlin, Germany. philipp.breuer@charite.de
• Acta Anaesthesiol Scand. 2010 Mar 1;54(3):313-20.

BackgroundShorter pre-operative fasting improves clinical outcome without an increased risk. Since October 2004, German Anaesthesiology Societies have officially recommended a fast of 2 h for clear fluids and 6 h for solid food before elective surgery. We conducted a nationwide survey to evaluate the current clinical practice in Germany.MethodsBetween July 2006 and January 2007, standardized questionnaires were mailed to 3751 Anaesthesiology Society members in leading positions requesting anonymous response.ResultsThe overall response rate was 66% (n=2418). Of those, 2148 (92%) claimed familiarity with the new guidelines. About a third (n=806, 34%) reported full adherence to the new recommendations, whereas 1043 (45%) reported an eased fasting practice. Traditional Nil per os after midnight was still recommended by 157 (7%). Commonest reasons reported for adopting the new guidelines were: 'improved pre-operative comfort' (84%), and 'increased patient satisfaction' (83%); reasons against were: 'low flexibility in operation room management' (19%), and 'increased risk of aspiration' (13%).ConclusionDespite the apparent understanding of the benefits from reduced pre-operative fasting, full implementation of the guidelines remains poor in German anaesthesiology departments.

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