1. Mathre, Mary Lynn RN

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After reading "Preoperative Fasting: Will the Evidence Ever Be Put into Practice?" (October 2011), I'd like to point out another reason for ending the standard practice of NPO (non per os, or nothing by mouth) after midnight before surgery, and this is based on personal experience.


I followed the preoperative instructions prior to a mastectomy. Usually my veins offer easy access when inserting an IV. Unfortunately, on the morning of my surgery, I was stuck five times in an effort to get an IV going. The preoperative nurse gave up after three tries; the anesthesiologist, on his second try, finally got one started in a vein in my foot. During this process, the anesthesiologist casually mentioned that there was evidence to support the notion that patients can consume clear liquids within a shorter time span before surgery.


How many other patients have been stuck numerous times before surgery, simply because they're dehydrated? It's painful, and it's a waste of time for staff to start an IV on a scheduled surgery patient who's dehydrated due to preoperative instructions.


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Mary Lynn Mathre, RN



Howardsville, VA