Public perceptions of preoperative fasting among the general public in Malta

Abstract

Preoperative fasting before general anesthesia is a crucial measure for reducing the risk of pulmonary aspiration. In Malta, patients are traditionally instructed by the Pre-Operative Assessment Clinic to commence fasting from midnight before their procedure. This practice persists despite local guidelines issued by Mater Dei Hospital (MDH), which recommend a fasting period of six hours for solid food and two hours for clear fluids. The MDH guidelines explicitly state that patients scheduled for morning surgery may consume solid food until midnight and clear fluids until 5:30a.m. Emerging research indicates that shorter fasting durations offer significant benefits, particularly for elderly individuals and young children. Consequently, several organizations, including the European Society of Anaesthesiology and Intensive Care (ESAIC), have issued guidelines advocating for a standardized, evidence-based approach to preoperative fasting. These recommendations seek to minimize the risk of pulmonary aspiration while enhancing patient comfort and clinical outcomes. The most recent ESAIC guidelines, published in 2011, prohibit solid food intake within six hours of surgery but permit the consumption of clear fluids up to two hours before the procedure. This study sought to evaluate public awareness and perceptions of preoperative fasting through two outreach events held in 2024: the Association of Anaesthesiologists of Malta’s stand at Science in the City 2024 in Valletta (September), and the World Anaesthesia Day celebrations at the Mater Dei Hospital main foyer (October).