{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T12:28:37Z","timestamp":1787228917842,"version":"build-2736575974"},"reference-count":52,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","license":[{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>Preoperative fasting was historically introduced to reduce pulmonary aspiration during anesthesia; however, contemporary evidence increasingly challenges the assumption that \u201clonger is safer.\u201d Aspiration is a rare event and is primarily determined by patient- and procedure-related risk factors rather than fasting duration alone, whereas prolonged fasting is consistently associated with patient discomfort and adverse physiological consequences. Risk assessment has become more complex with emerging clinical factors, most notably the widespread use of glucagon-like peptide-1 receptor agonists (GLP-1 RAs), which may delay gastric emptying and lead to residual solid gastric contents despite adherence to guideline-recommended fasting intervals. International recommendations for perioperative GLP-1 RA management remain heterogeneous, underscoring the need for pragmatic, risk-stratified strategies that balance aspiration risk mitigation with metabolic stability. Point-of-care gastric ultrasound is increasingly recognized as a valuable bedside decision-support tool, enabling qualitative and quantitative assessment of gastric contents in uncertain or high-risk scenarios and informing airway management and procedural timing. This review synthesizes the current evidence supporting liberal preoperative intake of clear liquids and highlights the transition from rigid, time-based rules toward individualized, physiology-informed approaches to perioperative hydration and nutrition.<\/jats:p>","DOI":"10.4103\/sja.sja_91_26","type":"journal-article","created":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T05:00:35Z","timestamp":1782968435000},"page":"665-674","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Modernizing perioperative fasting: Liberal clear liquids, glucagon-like peptide-1 receptor agonists, and point-of-care gastric ultrasound"],"prefix":"10.4103","volume":"20","author":[{"given":"Burhan","family":"Dost","sequence":"first","affiliation":[{"name":"Department of Anesthesiology and Reanimation, Ondokuz Mayis University Faculty of Medicine, Samsun, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Esra","family":"Turunc","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Reanimation, Ondokuz Mayis University Faculty of Medicine, Samsun, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Madan","family":"Narayanan","sequence":"additional","affiliation":[{"name":"Frimley Park Hospital, NHS Frimley Health Foundation Trust, Camberley, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kiran","family":"Koneti","sequence":"additional","affiliation":[{"name":"South Tyneside and Sunderland NHS Foundation Trust, Sunderland, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dario","family":"Bugada","sequence":"additional","affiliation":[{"name":"Department of Emergency and Critical Care, ASST Papa Giovanni XXIII, Bergamo, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yunus Emre","family":"Karapinar","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Reanimation, Istanbul University-Cerrahpasa Faculty of Medicine, Istanbul, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessandro","family":"De Cassai","sequence":"additional","affiliation":[{"name":"Department of Medicine (DIMED), University of Padua, Padua, Italy"},{"name":"Institute of Anesthesia and Intensive Care Unit, University Hospital of Padua, Padua, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2026,7,2]]},"reference":[{"key":"R2-20260820","doi-asserted-by":"crossref","first-page":"207","DOI":"10.1097\/EJA.0000000000002309","article-title":"Benefits in adults allowed to drink clear liquids before anaesthesia until called to the operating room: A randomised pilot study","volume":"43","author":"Haas","year":"2026","journal-title":"Eur J Anaesthesiol"},{"key":"R3-20260820","doi-asserted-by":"crossref","first-page":"617","DOI":"10.1093\/bja\/aer058","article-title":"Fourth National Audit Project. 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