Current practice of postoperative fasting: results from a multicentre survey in China

Abstract

ObjectiveA gap between clinical practice and evidence is common. The present multicentre study was designed to explore the actual postoperative fasting practice, including the instructed fasting time from the ward staff and the actual postoperative fasting time.DesignMulticentre survey.SettingFour tertiary hospitals in Shenzhen City, China.ParticipantsA total of 988 patients completed a survey on instructed and actual postoperative fasting.OutcomesAll patients received postoperative instructed fasting time from the ward staff. The median instructed fasting time for fluids from ward staff was 6 hours (IQR, 4–6 hours), and the median instructed fasting time for solid food was also 6 hours (IQR 5–6 hours) after surgery. The actual postoperative fasting time, including fluid and solid food intake, was significantly longer than the time recommended by the ward staff (both p<0.001).ResultsThe median time to postoperative first flatus (FFL) was 16.5 hours (IQR 8–25.5 hours), and the median time to postoperative first faeces (FFE) was 41 hours (IQR 25–57 hours). The fasting time was significantly shorter than the time to FFL and the time to FFE, regardless of surgery type or anaesthesia type (all p<0.001). Postoperative nausea and vomiting (PONV) occurred in 23.6% of patients. After surgery, 58.70% of patients reported thirst, and 47.47% reported hunger. No ileus occurred.ConclusionApproximately half of the patients reported thirst and hunger postoperatively. Patients initiated oral intake earlier than the time to FFL or FFE without increasing serious complications. This study may support the rationale for interventions targeting postoperative oral intake time in future studies.

Incidence and Associated Factors of Postoperative Undesirable Anesthetic Outcomes Among Surgical Patients at Referral Hospitals in Amhara Region, Ethiopia: A Multi-Center Study

“…In this study, the proportion of undesirable postoperative thirst was 73.5%. It is higher compared to previous study done in University of Gondar comprehensive and specialized hospital (59.4%), 16 Eritrea (27.7%), 1 China (58.7%) 17 and Taiwan University Hospital (55.8%). 18 This disparity could be attributable to an underestimation of the condition, since the quality of postoperative care varies by nation.…”

“…This result was higher than an Eritrean (18.3%) 1 and Chinese studies (47.47%). 17 This disparity could be attributed to the technique used to assess postoperative hunger and the quality of postoperative patient care, which varies by setting. Another possible explanation may be a difference between clinical practice and feeding protocols.…”

“…36 Hunger is a complex process involving neuronal and systemic components. 17 Early initiation of postoperative feeding accelerates bowel function recovery and decreases paralytic illus. 37,38 The prevalence of postoperative hunger was 50.9%.…”

Time to Start a New Enhanced Recovery After Surgery (ERAS): A Retrospective Cohort Study

“…This could be mitigated with a reduction of prolonged preoperative fasting and the provision of clear liquids with carbohydrates up to two hours before anesthetic induction [ 16 ]. It is recognized that these drinks improve general preoperative well-being, reduce postoperative insulin resistance, reduce protein loss, and maintain lean body mass and muscle strength [ 17 ].…”

Enhanced Recovery After Surgery (ERAS) Approach: A Medical Complex Experience

“…Primary outcomes included hospital stay length, survival rates, readmission and re-exploration rates, and postoperative complications (such as pulmonary thromboembolism, anastomotic leakage, and intestinal obstruction). Secondary measures involved pain levels measured using the visual analogue scale (VAS) [8], time to pass gas, first solid meal, and bowel function as assessed by PONV [9].…”