Abstract
“Nothing per os” (NPO) is a preoperative approach to prevent perioperative aspiration. As a result of the recent diffusion of a concept called “enhanced recovery after surgery” (ERAS) and the publication of various guidelines for preoperative fasting around the world, the duration of NPO has become shorter. Shortened NPO combined with dehydration correction and alimentation before surgery can enhance postoperative recovery and lead to shortened hospital stays.In Japan, routine healthcare services are provided under the national healthcare insurance system (medical fee scheme). So-called “diet therapy” is one of these services mentioned in the notification issued by the Director of the Medical Economics Division, Health Insurance Bureau, the Ministry of Health, Labor and Welfare. Anesthesiologists should take an interest in details of diet care determined by national systems, such as methods of instructions for diet therapy with or without dietary prescription. The “concept of diet therapy” proposed by the Japanese Society of Anesthesiologists provides points to note in giving patients instructions for preoperative hydration and alimentation. Anesthesiologists should know and understand these points.
