Adherence to Preoperative Fasting Guidelines in Elective Surgical Patients

Area of Science:

• Anesthesiology
• Surgical Patient Care
• Quality Improvement in Healthcare

Background:

• International guidelines recommend preoperative fasting to reduce aspiration risk during anesthesia.
• Prolonged preoperative fasting can lead to dehydration and electrolyte imbalance, negatively affecting surgical recovery.
• A prior study identified poor adherence to preoperative fasting guidelines, prompting an action plan.

Purpose of the Study:

• To evaluate compliance with a hospital action plan for preoperative fasting.
• To assess adherence to international consensus on preoperative fasting in surgical departments.
• To identify factors influencing preoperative fasting durations.

Main Methods:

• A survey of 306 adult patients undergoing elective cardiac, thoracic, and vascular surgery.
• Data collection on preoperative fasting duration for clear fluids and solid food over four months in 2023.
• Standardized questionnaires used to gather fasting information.

Main Results:

• Overall median fasting times were 4.5 hours for clear fluids and 14.5 hours for solid food.
• Extended fasting (over 12 hours for fluids, 24 hours for solids) was common, affecting 14.1% and 13.1% of patients, respectively.
• Afternoon surgeries were associated with significantly longer fasting periods compared to morning surgeries (p<0.001).

Conclusions:

• Patients frequently exceed recommended preoperative fasting times, deviating from global consensus.
• Afternoon surgery scheduling is linked to prolonged preoperative fasting durations.
• Improved adherence to preoperative fasting guidelines is necessary to optimize patient outcomes.