Abstract
Introduction: The typical order of nothing per oral (NPO) after midnight has been challenged in recent years, thus the American Society of Anesthesiology (ASA) revised in practice guidelines for preoperative fasting in healthy patients undergoing elective procedures, but many studies have showed that guidelines were not considered in clinical practice. The aim of this study was to evaluate the adjustment of preoperative NPO time with fasting guidelines in adult elective ophthalmic surgeries in a university educational ophthalmology hospital in Tabriz, Iran. Methods: In 3 months period, this descriptive study was conducted on 250 patients who scheduled for elective eye surgery. The investigator interviewed with patients before beginning of anesthesia and evaluated fasting duration for heavy meal, light meal and clear liquids and his or her satisfaction from NPO time and also investigated which staff recommended NPO time before anesthesia induction. Results: Fasting duration from heavy and light meal and clear liquids was 14.31 hours (8 - 23 hours), 12.46 hours (6 - 21 hours) and 11.54 hours (3 - 18 hours), respectively, that was not consistent with ASA guidelines. The discontent of the patients from prolonged NPO time was 60.8%. The most complaint was thirsty (42%). Ward nurses were the personnel who had the primary role in patients fasting time period (47.6%). Conclusion: Preoperative fasting duration for heavy and light meal and clear liquids for elective ophthalmic surgery in this teaching hospital was very long and not consistent with ASA guidelines. Ward nurses had the major role in this malpractice. Thus it seems that personnel education may be very helpful.
Highlights
The typical order of nothing per oral (NPO) after midnight has been challenged in recent years, the American Society of Anesthesiology (ASA) revised in practice guidelines for preoperative fasting in healthy patients undergoing elective procedures, but many studies have showed that guidelines were not considered in clinical practice
Average time of patients fasting in preoperational period was 12 - 24 hours and fasting times had clear differences with American Society of Anesthesiology’s recommendations [6]
Our researches concerning the American society of Anesthesiology standards in the field fasting time before surgery were consistent previous study [14]
Summary
The typical order of nothing per oral (NPO) after midnight has been challenged in recent years, the American Society of Anesthesiology (ASA) revised in practice guidelines for preoperative fasting in healthy patients undergoing elective procedures, but many studies have showed that guidelines were not considered in clinical practice. The aim of this study was to evaluate the adjustment of preoperative NPO time with fasting guidelines in adult elective ophthalmic surgeries in a university educational ophthalmology hospital in Tabriz, Iran. Conclusion: Preoperative fasting duration for heavy and light meal and clear liquids for elective ophthalmic surgery in this teaching hospital was very long and not consistent with ASA guidelines. It is routinely advised that patients must be fasted the night before surgery or at least 8 hours before operation, but numerous studies have showed that rate of vomiting and aspiration risk varies with different types of foods and liquids. Another study showed no differences among gastric acidity rate and contents volume of persons who were fasting all night and persons that drank water up to 3 hours before surgery [8]. We decided to design this study thereby, to obtain essential information about fasting time in adults patients who candidate for eye surgery
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