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Clifford Gevirtz, MD, MPH
Albert Einstein College of Medicine of Yeshiva University Bronx, NY

JAMA. 1990;264(1):33.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

To the Editor.—

Dr Meyer,¹ in his response to the question of mandatory "NPO" status for elective ambulatory surgery, expresses a humane and sensitive approach to this vexing problem. However, I was disappointed that he did not address the use of metoclopramide,^2(p438) of nonparticulate antacids,^2(p435) or of histamine₂-receptor antagonists³ in those ambulatory patients who have committed the minor transgression of stimulating gastric secretion by consumption of small amounts of clear liquids or chewing gum and candy.

I would add to his suggested strategies that some combination⁴ of the above agents might lessen the physical risk for these specific patients, as well as the medicolegal risk for the anesthesiologists. I would also caution against taking comfort in documenting the fact that the patient is accepting a slightly increased risk. The legal standard of maintenance of NPO status is firmly entrenched and even the most . . . [Full Text PDF of this Article]

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