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Observance of preoperative clear fluid fasting in pediatric anesthesia: oral and written information versus text
Alexandre Thomasseau1, Yohann Rebollar1, Maxime Dupuis1
1Service d'anesthésie-réanimation et médecine périopératoire, CHU de Poitiers, Poitiers cedex, France.
Insights
Sending a preoperative fasting reminder via text message significantly improved adherence to fasting rules in pediatric patients. This simple intervention enhanced patient safety by ensuring children followed essential pre-surgical guidelines.
Area of Science:
- Pediatric Surgery
- Anesthesiology
- Patient Safety
Background:
- Prolonged fasting before pediatric surgery is associated with adverse effects like hypotension and postoperative nausea.
- Current adherence to preanesthetic fasting guidelines is low, with only 30%-40% of cases complying.
- Effective strategies are needed to improve parental observance of fasting rules.
Purpose of the Study:
- To evaluate the efficacy of preoperative text message reminders in enhancing parental adherence to pediatric surgical fasting guidelines.
- To assess the impact of text message reminders on clear fluid fasting compliance and duration.
Main Methods:
- A before-and-after study was conducted with 172 pediatric patients under 15 years undergoing surgery.
- The control group received standard preanesthetic consultation regarding fasting rules.
- The intervention group received standard information plus a reminder text message the day before surgery.
Main Results:
- The text message group showed significantly higher observance of clear fluid fasting instructions (92% vs. 33%, OR 29.2, p < 0.001).
- The average fasting time for clear fluids was significantly shorter in the text message group (4.3 h ± 2.4 h vs. 8.7 h ± 4.8 h, p < 0.001).
Conclusions:
- Preoperative text message reminders sent the day before surgery significantly improve adherence to fasting rules in pediatric patients.
- This intervention offers a practical and effective method to enhance compliance with essential pre-surgical fasting protocols.
- Improved adherence to fasting guidelines can contribute to better patient outcomes and safety in pediatric surgery.
Introduction:
Prolonged fasting before surgery is common in pediatrics. In the literature, it is responsible for hypotension, irritability and postoperative nausea and vomiting. Despite clear instructions given during the preanesthetic consultation, fasting rules are respected in only 30%-40% of cases. We aimed to evaluate the benefit of sending a text message the day before surgery to improve the parents' observance of fasting rules.
Methods:
We conducted a before-and-after study at the University Hospital of Poitiers. From August to October 2018, 172 parents of children under 15 years of age scheduled for all types of surgery were enrolled into two groups according to the period: the control group with parents receiving information on preoperative fasting rules during the preanesthetic consultation several days before surgery, and the text message group, receiving the same information during consultation plus a text message the day before the surgery.
Results:
There was a difference in observance of clear fluid fasting instructions (between 2 and 3 h before the admission at hospital) in favor of the text message group 33% versus 92% OR 29.2 (10.9-95.2) p < 0.001, and in average fasting time for clear fluids 8.7 h ± 4.8 h vs. 4.3 h ± 2.4 h (p < 0.001).
Conclusion:
Sending of a reminder text message to the parents the day before the surgery resulted in a significant increase in observance of fasting rules in children undergoing scheduled surgery.
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