Pre-operative Fasting in Elective Adult Surgical Patients at a Tertiary Care Hospital in Sri Lanka

Abstract

Introduction: Preoperative fasting which is defined as “abstinence from all foods and liquids for a specified period of time before induction of anaesthesia and/or commencement of surgery”, is a time-tested practice that is undertaken for the benefit of patients presenting for surgery globally.Aim: To assess the current practice of preoperative fasting (POF) and to investigate the complications associated with prolong fasting among adult patients scheduled for elective surgery at Teaching Hospital Anuradhapura.Method: This clinical audit was performed using an interviewer-administered questionnaire. 430 adult patients awaiting elective surgery were interviewed following informed consent.Results: 95.3% thought POF was important but 55.6% lacked knowledge on the reason for POF. 52.8% of patients received instructions on POF by nurses, but only 32.6% of them were educated on the correct standards of POF. 67.4% of respondents who were educated by nurses were not told of the standards of POF. On average respondents fasted for 12.85 hours for solids and 7.38 hours for fluids. 85.7% fasted for more than 2 hours for clear fluids and 94.1% fasted for more than 6 hours for solids. 55.8% of the respondents complained of thirst and 11.6% and 5.1% had features of dehydration and postoperative nausea and vomiting respectively.Conclusions: Most patients fasted for both food and fluid longer than the fasting time recommended by the European Society of Anaesthesiology guidelines. It underscores the importance of educating the healthcare staff and patients on the updated guidelines.