1,056
edits
Changes
Jump to navigation
Jump to search
Line 48:
Line 48: − +
no edit summary
* Does setting realistic pain expectations in pre-op decrease self-reported pain scores in PACU?
* Does setting realistic pain expectations in pre-op decrease self-reported pain scores in PACU?
* Ultrasound vs blind A-line first attempt success rate and complications?
* Ultrasound vs blind A-line first attempt success rate and complications?
* How do epidurals affect gastric emptying in labor?
* [[Epidural Effect on Gastric Emptying|How do epidurals affect 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, remains 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.