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The October 2024 international consensus guidance, including from the American Society of Anesthesiologists, took a more nuanced position than earlier blanket-stop advice: 11 Patients on stable doses, without GI symptoms, who are not in the dose-escalation phase can usually continue their medication before elective surgery Higher-risk patients (recent dose escalation, GI symptoms, very high doses) should follow a 24-hour clear-liquid diet before standard 6-hour fasting For emergency surgery, the anaesthetist will use techniques that protect against aspiration regardless of fasting The specific plan should be agreed with your surgical team and anaesthetist in advance