The American Society of Anesthesiologists (ASA) guidelines were updated in 2011 to require fasting before undergoing general anesthesia to reduce the risk of aspiration pneumonia. However, fasting doesn't guarantee gastric emptying.

Since cataract surgery typically involves elderly patients, the concern with fasting is that it changes their normal routine, which can affect diabetes or other comorbidities, causing dehydration and altered blood glucose levels as well as increasing stress.

A small prospective case-control study involving 200 patients was conducted to find out how removing preoperative fasting affected patient satisfaction with the cataract surgery experience. 

Half of the patients followed the ASAS fasting guidelines while the other half were not required to fast. The goal was to discover the patient levels of comfort and postoperative incidence rates of nausea and vomiting. Patient satisfaction was scored on a scale from 1 to 5 with 1 indicating very dissatisfied and 5 indicating very satisfied.

The study results showed that patients who did not fast preoperatively had a better experience due to being able to maintain their normal routines and they were not as concerned about the effects of stopping medications. Researchers determined that removing preoperative fasting requirements did not increase risk of nausea, vomiting or aspiration but increased patient satisfaction preoperatively.


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