Changes

=Neuraxial Labor Analgesia and Gastric Emptying=

=Neuraxial Labor Analgesia and Gastric Emptying=

When did the ASA make their guideline for fasting? Which studies were cited? Which studies was the ASA (presumably) aware of? Ultimately, the clinical implications of answering this question would hinge on whether the results would change the ASA guidelines. If new information is unlikely to change guidance, then pursuing this question would be less relevant. Fasting for a few hours post-epidural is very low risk compared to the admittedly rare event of clinically significant aspiration. If you show that epidurals increase gastric emptying that would suggest that they also decrease risk of aspiration. However, if you then let patients with epidurals eat, they have a full stomach and their risk of aspiration is heightened despite any protective effect of an epidural. In other words, the lowest risk category of patients, assuming my hypothesis is true, is still fasted patients with epidurals.

When did the ASA make their guideline for fasting? Which studies were cited? Which studies was the ASA (presumably) aware of? Ultimately, the clinical implications of answering this question would hinge on whether the results would change the ASA guidelines. If new information is unlikely to change guidance, then pursuing this question would be less relevant. Fasting for a few hours post-epidural is very low risk compared to the admittedly rare event of clinically significant aspiration. If you show that epidurals increase gastric emptying that would suggest that they also decrease risk of aspiration. However, if you then let patients with epidurals eat, they have a full stomach and their risk of aspiration is heightened despite any protective effect of an epidural. In other words, the lowest risk category of patients, assuming my hypothesis is true, remains fasted patients with epidurals.

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