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Reducing preoperative fasting in elective adult surgical patients: a case–control study

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Abstract

Background

The practice of fasting from midnight prior to surgery is an outdated one.

Aims

The aim of this study was to assess the impact of an evidence-based protocol for reduced preoperative fasting on fasting times, patient safety, and comfort.

Methods

A non-randomised case–control study of preoperative fasting times among adult surgical patients undergoing elective procedures was conducted. Consecutive patients were allocated to a reduced preoperative fasting protocol allowing fluids and solids up to 2 and 6 h prior to anaesthesia, respectively (n = 21). These were compared to control patients identified from an historic study of preoperative fasting times who followed the traditional fast from midnight (n = 29). Fasting times and details of patients’ subjective comfort were collected using an interview-assisted questionnaire. Incidence of intraoperative aspirations was obtained from anaesthetic records.

Results

Significant reductions in fasting times for fluids (p = 0.000) and solids (p = 0.000) were achieved following implementation of the fasting protocol. Less preoperative thirst (0.000), headache (0.012) and nausea (0.015) were reported by those who had a shorter fast. Intraoperative aspiration did not occur in either group.

Conclusion

Implementation of this protocol for reduced preoperative fasting achieved an appreciable reduction in fasting times and enhanced patient comfort. Patient safety was not compromised. Further modifications of our protocols are necessary to meet the international best practice. We recommend its implementation across all surgical groups in our institution.

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Abbreviations

BMI:

Body mass index

GI:

Gastrointestinal

ERAS:

Enhanced recovery after surgery

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Acknowledgments

The authors wish to acknowledge the support of the theatre nurses and the nursing staff on Gogarty and Crampton Wards in the Adelaide and Meath Hospital Incorporating the National Childrens’ Hospital. Thank you to the surgical and anaesthetic teams for their participation in the study. Thank you to M. Roddy and S. Duggan for their expertise.

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Authors and Affiliations

  1. Department of Nutrition Dietetics, The Adelaide and Meath Hospital Incorporating the National Childrens’ Hospital, Tallaght, Dublin 24, Ireland

    S. Power, D. O. Kavanagh, G. McConnell, M. Leonard, A. Crean, S. Feehan, E. Eguare, P. Neary & J. Connolly

  2. School of Biological Sciences, Dublin Institute of Technology, Dublin, Ireland

    K. Cronin & C. Corish

Authors
  1. S. Power
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  2. D. O. Kavanagh
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  3. G. McConnell
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  4. K. Cronin
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  5. C. Corish
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  6. M. Leonard
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  7. A. Crean
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  8. S. Feehan
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  9. E. Eguare
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  10. P. Neary
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  11. J. Connolly
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Corresponding author

Correspondence to S. Power.

Additional information

This article was presented in the conference presentation of Irish Society of Gastroenterology (ISGE) Winter Meeting, Mullingar, Co., Westmeath on November 25th and 26th 2010.

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Power, S., Kavanagh, D.O., McConnell, G. et al. Reducing preoperative fasting in elective adult surgical patients: a case–control study. Ir J Med Sci 181, 99–104 (2012). https://doi.org/10.1007/s11845-011-0765-6

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  • DOI: https://doi.org/10.1007/s11845-011-0765-6

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