Understanding Anesthesiology - The Global Regional Anesthesia ...

NPO
NPO stands for “nil per os” and indicates that the patient has no oral intake of fluids or solids.
Each department of anesthesia has their own policy dictating how long a patient must be
“NPO” prior to surgery and anesthesia. Commonly-used guidelines are detailed below:
For elective surgery, patients should not have solid food for 8 hours prior to anesthesia. Unrestricted
intake of clear fluids is permitted until 2-4 hours prior to scheduled surgery.
Guidelines for pediatric patients are more liberal than in the adult population. For example,
infants may be allowed breast milk up to 4 hours pre-operatively and formula up to 6 hours
pre-operatively.
For emergency surgery, the risk of aspiration is weighed against the risk of delaying surgery
to achieve a longer “NPO” interval. It is important to realize that most patients undergoing
emergency surgery will have a “full stomach” regardless of how long they have been NPO
as the effects of trauma, pain, illness, opiates and other medications all serve to delay gastric
emptying.
Related Glossary Terms
Aspiration, Clear fluids, Cricoid cartilage, Rapid sequence induction, Sellick’s maneuver
Index
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Chapter 2 - Pre-operative Evaluation
Chapter 5 - Obstetrical Anesthesia
Chapter 5 - Pediatric Anesthesia