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Preoperative fasting times in elective surgical patients at a referral Hospital in Botswana
Worknehe Agegnehu Abebe1, Ambrose Rukewe1, Negussie Alula Bekele1
1University of Botswana, University of Botswana, Department of Anesthesia & Critical Care, Gaborone, Botswana.
Insights
Patients undergoing surgery fasted significantly longer than recommended guidelines, with mean fasting periods for liquids and solids exceeding American Society of Anesthesiologists (ASA) guidelines. This highlights the need for improved preoperative fasting policies.
Area of Science:
- Anesthesiology
- Surgical Patient Care
Background:
- Preoperative fasting is crucial to prevent aspiration during anesthesia.
- Prolonged fasting periods can lead to complications and are often unnecessary.
Purpose of the Study:
- To evaluate current preoperative fasting practices in a specific center.
- To compare these practices against American Society of Anesthesiologists (ASA) guidelines.
- To identify factors influencing preoperative fasting durations.
Main Methods:
- A cross-sectional study involving 260 elective surgical patients.
- Data collected via questionnaires administered upon patient arrival at the operating theatre reception.
- Analysis of patient fasting times for solids and liquids.
Main Results:
- Most patients (98.1%) were instructed to fast from midnight.
- Mean fasting duration for solids was 15.9±2.5 hours and for liquids was 15.3±2.3 hours.
- Fasting durations were significantly longer for patients scheduled for afternoon surgery (p<0.001).
Conclusions:
- Mean fasting periods significantly exceeded ASA guidelines (7.65x for clear liquids, 2.5x for solids).
- Hospitals must establish clear preoperative fasting policies.
- Staff education is essential to ensure compliance with evidence-based guidelines.
Introduction:
Adults and children are required to fast before anaesthesia to reduce the risk of regurgitation and aspiration of gastric contents. However, prolonged periods of fasting are unnecessary and may cause complications. This study was conducted to evaluate preoperative fasting period in our centre and compare it with the ASA recommendations and factors that influence fasting periods.
Methods:
This is a cross-sectional study of preoperative fasting times among elective surgical patients. A total numbers of 260 patients were interviewed as they arrived at the reception area of operating theatre using questionnaire.
Results:
Majority of patients (98.1%) were instructed to fast from midnight. Fifteen patients (5.8%) reported that they were told the importance of preoperative fasting. The mean fasting period were 15.9±2.5 h (range 12.0-25.3 h) for solids and 15.3±2.3 h (range 12.0-22.0 h) for liquids. The mean duration of fasting was significantly longer for patients operated after midday compared to those operated before midday, p<0.001.
Conclusion:
The mean fasting periods were 7.65 times longer for clear liquid and 2.5 times for solids than the ASA guidelines. It is imperative that the Hospital should establish Preoperative fasting policies and teach the staff who should ensure compliance with guidelines.
