术前禁食和目击肺吸气之间没有关联:系统性审查和元分析
Stephanie Lam1, Maxime P Cannesson1, Antonia Osuna-Garcia2
1Department of Anesthesia, UCLA School of Medicine, Los Angeles, CA.
Surgery
|June 12, 2025
概括
手术前的禁食不会影响吸血风险. 目前的证据表明,程序前禁食指南可能会被自由化,可能使用胃超声波来评估胃体积.
科学领域:
- 麻醉学 麻醉学
- 手术护理 手术护理
- 患者安全 患者安全
背景情况:
- 自1946年以来,基于胃体积和吸入风险之间的关联,手术前禁食已成为标准.
- 有大量关于禁食对代孕结果的影响的文献,但很少有研究关注作为主要结果的愿望.
研究的目的:
- 评估各种手术前禁食方案对临床期望事件的影响.
- 评估代理标记 (胃体积,pH) 与实际吸入之间的相关性.
主要方法:
- 随机临床试验和观察性研究 (2016-2023) 关于手术前禁食和渴望的系统审查和元分析.
- 主要结局:临床愿望. 二次结果:胃体积和pH值.
- 试验顺序分析,以确定有关禁食对渴望的影响的研究结果的确定性.
主要成果:
- 在术前禁食和临床吸收事件 (OR=1.17,P=.81) 之间没有发现显著的关联.
- 吸血是罕见的,在禁食和对照组中都有类似的低发病率 (0.50%对0.71%).
- 没有证实胃体积和pH等替代结果与麻醉相关的吸收相关.
结论:
- 自由化的禁食政策与增加的目击者愿望没有任何关联.
- 对自由禁食的进一步研究不太可能改变目前关于愿望风险的结论.
- 考虑床边胃超声波可能是传统禁食协议的可行替代方案.
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