A healthy adult is listed first on the morning elective list for inguinal hernia repair under general anaesthesia. At 5 AM, three hours before arrival, she drank a cup of tea with a small amount of milk. What is the most appropriate action?
- A Delay surgery until six hours have elapsed from the intake ✓
- B Proceed, since three hours exceeds the safe interval for any liquid
- C Proceed as planned, since tea is a clear fluid
- D Give a prokinetic and an H2 blocker, then proceed immediately
Correct answer: A. Delay surgery until six hours have elapsed from the intake
Explanation
Milk-containing beverages are treated as solids because fat delays gastric emptying, so the six-hour rule for a light meal applies, not the two-hour rule for clear fluids such as black tea, black coffee, or water. Option B fails because three hours is insufficient for a milky drink. Pharmacological prophylaxis does not replace fasting requirements and does not guarantee an empty stomach. Clear fluids remain permissible up to two hours before induction.
Reference: Morgan and Mikhail's Clinical Anesthesiology, 6th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.