Abstract
Background Preoperative fasting is a requisite before anesthesia. The main reason for preoperative fasting is to reduce gastric volume and acidity and thus decrease the risk of pulmonary aspiration. However, preoperative fasting is usually prolonged beyond the recommended time for various reasons. Despite the many adverse effects of prolonged fasting, patients sometimes fasted for a prolonged time when surgery was delayed for different reasons at the University of Gondar Hospital. The aim of this study was to assess the duration of preoperative fasting for elective surgery.MethodsA cross-sectional study was conducted from March 10 to April 10, 2013. Patients were interviewed 24 h after surgery. All 43 patients who were under anesthesia while operated on during the study period were included.Result Of the 43 patients included in the study, 35 were adults and 8 were children. The minimum, maximum, and mean fasting hours for food were 5, 96, and 19.60, respectively, and more than 50 % of the patients fasted from food twice as long as recommended. The minimum, maximum, and mean fasting hours for fluid were 5, 19, and 12.72, respectively. More than 95 % of the patients fasted from fluid longer than recommended.ConclusionMost patients fasted from both food (92 %) and fluid (95 %) longer than the fasting time recommended by the AAGBI, ASA, RCOA, and RCN fasting guidelines. Anesthetists, surgeons, and nurses need to revise operation lists every day in the operating theatres and resuscitate the patients when surgery is delayed for various reasons. A preoperative fasting guideline should be developed and implemented in the University of Gondar Hospital.
Highlights
Anesthesia-related pulmonary aspiration that may lead to respiratory failure has been mentioned in both elective and emergency surgery patients
Most patients fasted from both food (92 %) and fluid (95 %) longer than the fasting time recommended by the Anaesthetists of Great Britain and Ireland (AAGBI), American Society of Anesthesiologists (ASA), RCOA, and Royal College of Nursing (RCN) fasting guidelines
43 (82.7 %) of the 52 elective surgery patients were included in our audit
Summary
Anesthesia-related pulmonary aspiration that may lead to respiratory failure has been mentioned in both elective and emergency surgery patients. Fluid and food intake by healthy and elective surgery patients may increase aspiration risk by increasing residual gastric volume, decreasing pH, and decreasing esophageal sphincter tone. Preoperative fasting is advised to keep patients nil per os (NPO) from food and drink from midnight before the day of surgery to minimize the risk of pulmonary aspiration [1,2,3]. The order NPO starting at midnight for elective surgery can be adjusted to no intake of solid food and milk products 6 h before surgery and fast from clear fluid 2 h before surgery [4,5,6,7,8,9,10]. The main reason for preoperative fasting is to reduce gastric volume and acidity and decrease the risk of pulmonary aspiration. More than 95 % of the patients fasted from fluid longer than recommended
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