Preoperative Fasting Duration and Medication Instruction: Are We Improving?

Winslow, Elizabeth H.

doi:10.1016/j.aorn.2008.07.017

Cited by 33 publications

(32 citation statements)

References 35 publications

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“…Obviously we should intensify our education for health care professionals and caregivers. Behavioral changes concerning fasting times already pose a challenge in the developed world, 24 and easily overstretch our limited staff resources. It might seem easy to give the necessary information and training and to ask the question "when was the last time your child drank before the operation?…”

Section: Discussionmentioning

confidence: 99%

Excessive fasting times: still an underaddressed challenge for African pediatrics and anesthesia?

Pollach¹,

Kapenda²,

Anusa³

et al. 2014

PHMT

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Background: Children are starved before surgery following international preoperative guidelines. Extreme fasting is still reported, but data for Africa are scarce. Starving in hot climates leads to challenges arising from dehydration, hypotension, metabolic disturbances, and complications during induction of anesthesia. The purpose of this study was to evaluate the scope of the problem, identify possible reasons for this, and propose realistic solutions. Methods: We performed eleven prospective audits between 2008 and 2013 in Malawi to improve our preoperative fasting times. In total, 631 children (aged 3 days to 13 years) were monitored. Training was provided, and the results were measured using a visual analog scale. Conclusion:Excessive preoperative fasting is an underaddressed problem in Africa. Reduction is difficult, so it has to be accepted as an ongoing task.

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Section: Discussionmentioning

confidence: 99%

Excessive fasting times: still an underaddressed challenge for African pediatrics and anesthesia?

Pollach¹,

Kapenda²,

Anusa³

et al. 2014

PHMT

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“…9 Penelitian di Amerika Serikat menunjukkan durasi puasa makanan padat 6-37 jam dengan rata-rata 14,5 jam. 10 Hampir semua penelitian dan survei tentang puasa preoperatif mendapatkan hasil yang lebih lama daripada pedoman puasa preoperatif dari ASA 11 dan walaupun sudah diupayakan kampanye pedoman puasa preoperatif kepada dokter anestesi, dokter bedah, dan perawat di bangsal, hal ini tetap masih sulit diubah. 10 Puasa dari minuman rata-rata 8,06 jam dengan rentang durasi mulai dari 2 jam hingga 18 jam.…”

Section: 2unclassified

“…10 Hampir semua penelitian dan survei tentang puasa preoperatif mendapatkan hasil yang lebih lama daripada pedoman puasa preoperatif dari ASA 11 dan walaupun sudah diupayakan kampanye pedoman puasa preoperatif kepada dokter anestesi, dokter bedah, dan perawat di bangsal, hal ini tetap masih sulit diubah. 10 Puasa dari minuman rata-rata 8,06 jam dengan rentang durasi mulai dari 2 jam hingga 18 jam. Penelitian di Australia didapatkan puasa dari minuman rata-rata 9,4 jam, 9 sedangkan di Amerika Serikat durasi puasa dari minuman 3-20 jam dan rata-rata 11,9 jam.…”

Section: 2unclassified

Hubungan antara Durasi Puasa Preoperatif dan Kadar Gula Darah Sebelum Induksi pada Pasien Operasi Elektif di Rumah Sakit Dr. Hasan Sadikin Bandung

Hartanto¹,

Suwarman²,

Sitanggang³

2016

jap

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AbstrakPuasa preoperatif merupakan keharusan sebelum dilakukan tindakan anestesi. Alasan utamanya adalah untuk mengurangi volume lambung, tingkat keasaman lambung, dan mengurangi risiko aspirasi paru. Namun, puasa preoperatif sering kali lebih lama daripada yang direkomendasikan karena berbagai sebab. Tujuan penelitian ini mengetahui durasi puasa preoperatif pada pasien operasi elektif dan hubungan antara durasi puasa preoperatif dan kadar gula darah sebelum induksi pasien operasi elektif di Rumah Sakit Dr. Hasan Sadikin Bandung. Penelitian observasional dilakukan selama 1-31 Juni 2014 dengan melakukan wawancara pasien sebelum induksi anestesi dan pengukuran kadar gula darah menggunakan glukometer. Analisis korelasi menggunakan Uji Mann-Whitney. Hasil penelitian pada 371 pasien didapatkan lama puasa dari makanan padat, durasi minimum adalah 4 jam, maksimum 20,5 jam, dan rata-rata 10,42 jam. Pada puasa dari minuman, durasi puasa minimum adalah 2 jam, maksimum 18 jam dengan rata-rata 8,06 jam. Terdapat 8 pasien dengan kadar gula darah kurang dari 70 mg/dL dengan rentang kadar gula darah 59-70 mg/dL dan rentang durasi puasa 6-18 jam. Tiga di antaranya orang lanjut usia di atas 60 tahun. Sebanyak 253 pasien berpuasa makanan padat >8 jam dan 357 pasien berpuasa minuman >2 jam. Simpulan, tidak terdapat hubungan antara durasi puasa dan kadar gula darah sebelum induksi.Kata kunci: Durasi puasa preoperatif, kadar gula darah, operasi elektif Correlation between Preoperative Fasting Duration and Blood Glucose Level before Induction in Elective Surgery Patients in Dr. Hasan Sadikin General Hospital Bandung AbstractPreoperative fasting is a requisite before anesthesia. The main reason for preoperative fasting is to reduce gastric volume and acidity and, thus, decrease the risk of pulmonary aspiration. However, preoperative fasting is usually prolonged beyond the recommended time for various reasons. Despite the many adverse effects of prolonged fasting, patients sometimes fast for a prolonged time when the surgery is delayed for different reasons. The aim of this study was to assess the duration of preoperative fasting for elective surgery and its correlation with blood glucose after preoperative fasting in Dr. Hasan Sadikin General Hospital Bandung. An observational study was conducted from 1-31 June 2014. Patients were interviewed before induction, and blood glucose level was measured using a glucometer. A correlation analysis was performed using Mann-whitney test. All 371 elective surgery patients admitted during the study period were included. The minimum, maximum, and mean fasting hours for food were 4, 20.5, and 10.42, respectively. The minimum, maximum, and mean fasting hours for fluid were 2, 18, and 8.06, respectively. Only 8 patients had blood a glucose level below 70 mg/dL with blood glucose levels range from 59 to 70 mg/dL and duration of fasting range from 6 to 18 hours. Three of elderly patients, who was above 60 years old, participated in this study. There were 253 patients (68.2%) fasted from solid food more ...

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“…Strict fasting rules implementation will lead to usual routine fasts after midnight (6). Moreover, experiences manifested that the fasting period is usually too long and its starting point is different from evening (after having dinner) to midnight, and it seems that this period is not related to surgery time and the patient's condition.…”

Section: Introductionmentioning

confidence: 99%

“…The high prevalence of aspiration reported by Mendelson in 1946 was 0.15 percent that is five times more than the one (0.04percent) reported by Olsson et al,.Tirt et al, (0.01%) and Warner et al 's (0.04%) finding. Digestion period is subject to the kind of consumed food, the fasting time around 6 h is enough for making sure of gastric depletion, and it has been proved that such a long stretching of fast is unnecessary for liquids consumption before surgery (6,7). Liquids and water remain in stomach for only 12 minutes and surveys have revealed that the volume and PH of stomach or plasma osmolarity would not be affected by unlimited water intake until 2 h prior to surgery (8).…”

Section: Introductionmentioning

confidence: 99%