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Erschienen in: Indian Journal of Surgery 6/2018

01.12.2018 | Original Article

Preoperative Fasting and Patients’ Discomfort

verfasst von: Asiye Gul, Isil Isik Andsoy, Birgul Ozkaya

Erschienen in: Indian Journal of Surgery | Ausgabe 6/2018

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Abstract

Excessive fasting times before surgery continue to be a widespread practice in Turkey. The aim of the study was to determine the relationship between traditional fasting policies and preoperative patient discomfort. Patients included were undergoing breast, hernia, thyroid, or abdominal operations at a general surgery clinic. Participants were classified as American Society of Anesthesiologists physical statuses I and II. A Likert-type scale was used to describe the effects of midnight fasting. Peripheral blood sugar and vital signs were measured immediately before induction of anesthesia. Of 164 participants, mean age was 53.56 ± 13.47 years. Mean preoperative fasting times were 13.34 ± 3.07 h for solids and 12.44 ± 2.82 h for fluids. Immediately before surgery, 6.1% of patients were extremely thirsty, 5.5% were hungry, and 39% had mild dryness of the mouth. There was a weak positive correlation between total duration of solid fasting and thirst, hunger, mouth dryness, and weakness immediately preoperatively. Prolonged fasting before surgery was associated with patients’ discomfort. Current evidence-based guidelines for preoperative fasting may improve patients’ satisfaction.
Literatur
1.
Zurück zum Zitat Bopp C, Hoper S, Klein A, Weigand MA, Martin E, Gust R (2011) A liberal preoperative fasting regimen improves patient comfort and satisfaction with anesthesia care in day-stay minor surgery. Minerva Anestesiol 77:680–686PubMed Bopp C, Hoper S, Klein A, Weigand MA, Martin E, Gust R (2011) A liberal preoperative fasting regimen improves patient comfort and satisfaction with anesthesia care in day-stay minor surgery. Minerva Anestesiol 77:680–686PubMed
2.
Zurück zum Zitat Ludwig RB, Paluda J, Fernandes D, Scherer F (2013) Lesser time of preoperative fasting and early postoperative feeding are safe. Arg Bras Cir dig 26:54–58CrossRef Ludwig RB, Paluda J, Fernandes D, Scherer F (2013) Lesser time of preoperative fasting and early postoperative feeding are safe. Arg Bras Cir dig 26:54–58CrossRef
3.
Zurück zum Zitat Manchikanti L, Malla Y, Wargo BW, Fellows B (2011) Preoperative fasting before interventional techniques: is it necessary or evidence-based. Pain Physician 14:459–467PubMed Manchikanti L, Malla Y, Wargo BW, Fellows B (2011) Preoperative fasting before interventional techniques: is it necessary or evidence-based. Pain Physician 14:459–467PubMed
4.
Zurück zum Zitat Lambert E, Carey S (2015) Practice guideline recommendation on perioperative fasting: a systematic review. J Parenter Enteral Nutr Lambert E, Carey S (2015) Practice guideline recommendation on perioperative fasting: a systematic review. J Parenter Enteral Nutr
5.
Zurück zum Zitat Gül A, Andsoy II, Üstündağ H, Özkaya BÖ (2013) Assessment of preoperative fasting time in elective general surgery. The Journal of Macro Trends in Health and Medicine 1:1–8 Gül A, Andsoy II, Üstündağ H, Özkaya BÖ (2013) Assessment of preoperative fasting time in elective general surgery. The Journal of Macro Trends in Health and Medicine 1:1–8
6.
Zurück zum Zitat Khoyratty S, Modi BN, Ravichandran D (2010) Preoperative starvation in elective general surgery. J Perioper Pract 20:100–102CrossRefPubMed Khoyratty S, Modi BN, Ravichandran D (2010) Preoperative starvation in elective general surgery. J Perioper Pract 20:100–102CrossRefPubMed
7.
Zurück zum Zitat Power S, Kavangh DO, McConnell G, Cronin K, Corish C, Leonard M, Crean A, Feehan S, Eguare E, Neary P, Connolly J (2012) Reducing preoperative fasting in elective adult surgical patients: a case-control study. Ir J med Sci 181:99–104CrossRefPubMed Power S, Kavangh DO, McConnell G, Cronin K, Corish C, Leonard M, Crean A, Feehan S, Eguare E, Neary P, Connolly J (2012) Reducing preoperative fasting in elective adult surgical patients: a case-control study. Ir J med Sci 181:99–104CrossRefPubMed
8.
Zurück zum Zitat de Andrade Gagheggi Ravanini G, Portari Filho PE, Abrantes Luna R, Almeida de Oliveira V (2015) Organic inflammatory response to reduced preoperative fasting time, with a carbohydrate and protein enriched solution; a randomized trial. Nutr Hosp 32(2):953–957PubMed de Andrade Gagheggi Ravanini G, Portari Filho PE, Abrantes Luna R, Almeida de Oliveira V (2015) Organic inflammatory response to reduced preoperative fasting time, with a carbohydrate and protein enriched solution; a randomized trial. Nutr Hosp 32(2):953–957PubMed
9.
Zurück zum Zitat Hamid S (2014) Pre-operative fasting a patient centered approach. BMJ Qual Improv Report 23:1–4 Hamid S (2014) Pre-operative fasting a patient centered approach. BMJ Qual Improv Report 23:1–4
10.
Zurück zum Zitat Gemremedhn EG, Nagaratnam VB (2014) Audit on preoperative fasting of elective surgical patients in an African Academic Medical Center. World J Surg 38:2200–2204CrossRef Gemremedhn EG, Nagaratnam VB (2014) Audit on preoperative fasting of elective surgical patients in an African Academic Medical Center. World J Surg 38:2200–2204CrossRef
11.
Zurück zum Zitat Tosun B, Yava A, Açıkel C (2015) Evaluating the effects of preoperative fasting and fluid limitation. Int J Nurs Pract 21:1156–1165CrossRef Tosun B, Yava A, Açıkel C (2015) Evaluating the effects of preoperative fasting and fluid limitation. Int J Nurs Pract 21:1156–1165CrossRef
12.
Zurück zum Zitat Falconer R, Skouras C, Carter T, Greenway L, Paisley AM (2014) Preoperative fasting: current practice and areas for improvement. Updat Surg 66(1):31–39CrossRef Falconer R, Skouras C, Carter T, Greenway L, Paisley AM (2014) Preoperative fasting: current practice and areas for improvement. Updat Surg 66(1):31–39CrossRef
13.
Zurück zum Zitat de Aguilar-Nascimento JE, de Almeida Dias AL, Dock-Nascimento DB, Correia MITD, Campos ACL, Portari-Filho PE, Oliveira SS (2014) Actual preoperative fasting time in Brazilian hospitals: the BIGFAST multicenter study. Ther Clin Risk Manag 10:107–112 de Aguilar-Nascimento JE, de Almeida Dias AL, Dock-Nascimento DB, Correia MITD, Campos ACL, Portari-Filho PE, Oliveira SS (2014) Actual preoperative fasting time in Brazilian hospitals: the BIGFAST multicenter study. Ther Clin Risk Manag 10:107–112
14.
15.
Zurück zum Zitat Dolgun E, Taşdemir N, Ter N, Yavuz M (2011) Investigation of preoperative fasting times of surgical patients. Fırat University Medical Journal of Health Sciences 25:11–15 Dolgun E, Taşdemir N, Ter N, Yavuz M (2011) Investigation of preoperative fasting times of surgical patients. Fırat University Medical Journal of Health Sciences 25:11–15
16.
Zurück zum Zitat Aroni P, do Nascimento LA, Fonseca LF (2012) Assessment strategies for the management of thirst in the post-anesthetic recovery room. Acta Paul Enferm 25:530–536CrossRef Aroni P, do Nascimento LA, Fonseca LF (2012) Assessment strategies for the management of thirst in the post-anesthetic recovery room. Acta Paul Enferm 25:530–536CrossRef
17.
Zurück zum Zitat Karadağ M, Pekinİşeri Ö (2014) Determining health personnel’s application trends of new guidelines for preoperative fasting: findings from a survey. J Peri Anesth Nurs 29:175–184CrossRef Karadağ M, Pekinİşeri Ö (2014) Determining health personnel’s application trends of new guidelines for preoperative fasting: findings from a survey. J Peri Anesth Nurs 29:175–184CrossRef
18.
Zurück zum Zitat Lim HJ, Lee H, Ti LK (2014) An audit of preoperative fasting compliance at a major tertiary referral hospital in Singapore. Singap med J 55(1):18–23CrossRef Lim HJ, Lee H, Ti LK (2014) An audit of preoperative fasting compliance at a major tertiary referral hospital in Singapore. Singap med J 55(1):18–23CrossRef
19.
Zurück zum Zitat Crenshaw JT (2011) Preoperative fasting: will the evidence ever be put into practice. Am J Nurse 111(10):38–43 Crenshaw JT (2011) Preoperative fasting: will the evidence ever be put into practice. Am J Nurse 111(10):38–43
20.
Zurück zum Zitat Andrew-Romit JJ, van de Mortel TF (2011) Ritualistic preoperative fasting: is it still occurring and what can we do about it. The Journal of Perioperative Nursing in Australia 24(1):14–19 Andrew-Romit JJ, van de Mortel TF (2011) Ritualistic preoperative fasting: is it still occurring and what can we do about it. The Journal of Perioperative Nursing in Australia 24(1):14–19
21.
Zurück zum Zitat Bower WF, Lee PY, Kong AP, Jiang JY, Underwood MJ, Chan JC, van Hasselt CA (2010) Peri-operative hyperglycemia: a consideration for general surgery. Am J Surg 199(2):240–248CrossRefPubMed Bower WF, Lee PY, Kong AP, Jiang JY, Underwood MJ, Chan JC, van Hasselt CA (2010) Peri-operative hyperglycemia: a consideration for general surgery. Am J Surg 199(2):240–248CrossRefPubMed
22.
Zurück zum Zitat Mannix T (2014) Nil by mouth: best practice and patient education. Nurs Times 110(26):12–14 Mannix T (2014) Nil by mouth: best practice and patient education. Nurs Times 110(26):12–14
24.
Zurück zum Zitat Gunawardhana AI (2012) Knowledge, attitudes and practice of preoperative fasting guidelines in the National Hospital of Sri Lanka. Sri Lankan Journal of Anesthesiology 20:92–95CrossRef Gunawardhana AI (2012) Knowledge, attitudes and practice of preoperative fasting guidelines in the National Hospital of Sri Lanka. Sri Lankan Journal of Anesthesiology 20:92–95CrossRef
25.
Zurück zum Zitat Bothamley J, Mardell A (2005) Preoperative fasting revisited. Br J Perioper Nurs 15:370–374PubMed Bothamley J, Mardell A (2005) Preoperative fasting revisited. Br J Perioper Nurs 15:370–374PubMed
26.
Zurück zum Zitat Salman OH, Asida SM, Ali HS (2013) Current knowledge, practice and attitude of preoperative fasting: a limited survey among Upper Egypt anesthetists. Egyptian Journal of Anaesthesia 29:125–130CrossRef Salman OH, Asida SM, Ali HS (2013) Current knowledge, practice and attitude of preoperative fasting: a limited survey among Upper Egypt anesthetists. Egyptian Journal of Anaesthesia 29:125–130CrossRef
27.
Zurück zum Zitat Melnyk M, Casey RG, Black P, Koupparis AJ (2011) Enhanced recovery after surgery (ERAS) protocols: time to change practice. Can Ural Assoc J 5(5):342–348CrossRef Melnyk M, Casey RG, Black P, Koupparis AJ (2011) Enhanced recovery after surgery (ERAS) protocols: time to change practice. Can Ural Assoc J 5(5):342–348CrossRef
28.
Zurück zum Zitat Protic A, Turina D, Matanic D, Spanjol J, Zuvic-Butorac M, Sustic A (2010) Effect of preoperative feeding on gastric emptying following spinal anesthesia: a randomized controlled trial. Wien Klin Wochenschr 122:50–53CrossRefPubMed Protic A, Turina D, Matanic D, Spanjol J, Zuvic-Butorac M, Sustic A (2010) Effect of preoperative feeding on gastric emptying following spinal anesthesia: a randomized controlled trial. Wien Klin Wochenschr 122:50–53CrossRefPubMed
29.
Zurück zum Zitat Liddle C (2014) Nil by mouth: best practice patient education. Nurs Times 110(26):12–14PubMed Liddle C (2014) Nil by mouth: best practice patient education. Nurs Times 110(26):12–14PubMed
Metadaten
Titel
Preoperative Fasting and Patients’ Discomfort
verfasst von
Asiye Gul
Isil Isik Andsoy
Birgul Ozkaya
Publikationsdatum
01.12.2018
Verlag
Springer India
Erschienen in
Indian Journal of Surgery / Ausgabe 6/2018
Print ISSN: 0972-2068
Elektronische ISSN: 0973-9793
DOI
https://doi.org/10.1007/s12262-017-1657-4

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