Aims: Brachial plexus block (BPB) is commonly performed as the sole anaesthetic technique for hand surgery. There is clear evidence that patients are usually starved for much longer than expected and this might have serious consequences on susceptible patients. We aimed to explore anaesthetists’ views on fasting before hand surgery performed under BPB.

Method: After departmental approval, we conducted a national survey in two big teaching hospitals in London and Stoke-on-Trent. We asked 120 anaesthetists the question: “Do you believe patients should be fasted for hand surgery under BPB if we are not using sedation?”

Results: Out of 120 anaesthetists, 65 were consultants and 55 were trainees. The most commonly performed BPB was axillary (39%). Ultrasound was used in 92% of BPBs. 37.5 % of anaesthetists disagreed with fasting patients before BPB (45% consultants and 55% trainees). 37% of anaesthetists with over 5yrs experience in regional anaesthesia believed that patients should not be fasted. 47% of anaesthetists who perform over 100 BPBs and 44% of anaesthetists who do regular lists under BPB disagreed with fasting. Out of 75 who agreed with fasting, 53% had experience of converting BPB to GA as opposed to 38% of those who disagreed.

Conclusion: Our survey showed that although the majority of UK anaesthetists are in favour of fasting before BPB for hand surgery, a significant proportion disagreed. It also showed that having more experience in BPB and doing them regularly did not change the majority vote. It would be interesting to explore anaesthetists’ ideas and surgeons’ views worldwide.