Effect of total fasting hours on the overall quality of recovery after surgery: An observational study.

Abstract

Preoperative fasting is one of the pre-requisite for patients undergoing a surgery. Despite clear instructions, patients frequently fast for extended periods before elective surgeries. Longer periods of fasting may cause discomfort, thirst, hunger, and other physiological problems. To assess the quality of postoperative recovery among adult patients having different preoperative fasting hours by using the postoperative Quality of Recovery40 (QoR40) score. This was an observational study that was conducted for adult patients undergoing elective surgery during four weeks between 19th September and 13th October 2022 at Security Forces Hospital Riyadh, Kingdom of Saudi Arabia. We excluded pediatric patients, patients undergoing spine or neurosurgery, emergency cases, or local anesthesia cases. Non-probability convenient sampling technique was used in this study. The postoperative quality of recovery-40 (QoR-40) questionnaire was distributed among 200 patients. All analyses were performed with Statistical Package for the Social Sciences software (SPSS) v25. Descriptive statistics (frequency, percentage, median, and IQR) were used for the questionnaire's variables. The difference between the variables was analyzed using Kruskal-Wallis, and a P value <0.05 was considered statistically significant. Out of 200 patients, 172 patients responded but 16 responses were excluded. A total of 156 adult patients' responses were included in this study. The majority were female (53%), 31% were older than 45 years. More than 50% of patients reported fasting for more than 6 hours for drinking and more than 8 hours for eating. On the positive scale, the comfort score was significantly affected by the fasting hours for drinking (P value = 0.045). On the negative scale of the questionnaire, the emotions were significantly affected by fasting hours for both drinking (P value = 0.027) and eating (P value = 0.043). The study results showed better comfort for patients with lesser fasting hours for drinking. Moreover, the results strongly suggest the need of following the fasting guidelines without prolonging the fasting duration. However, further studies with larger sample sizes are recommended.