Shorter Fasting Time Before & After Operations: Need to Change the Traditional Fasting Protocols of Surgical Patients?

Abstract

Objective: To provide evidence that shorter fasting time, until 2 hours before and after elective operations under general anesthesia (GA) or subarachnoid block (SAB) is more beneficial and equally safe than traditional 6-8 hours nil per oral (NPO)fasting.

Study Design: Course Comparative / descriptive study

Place and Duration of Study: This study was conducted at Sheikh Khalifa Bin Zayad Alnayan Hospital (CMH) Rawalakot Azad Kashmir from January to Oct 2019.

Materials and Methods: Recovery indicators and complications were assessed in 100 selected patients of four different specialties for elective operations under GA and SAB in a tertiary care SKBZAN Hospital (CMH) Rawalakot through a performa. These patients were divided manually into two equal unmatched groups by odd and even numbers. Group-A included 50 patients who were advised routine protocol of preoperative fasting after midnight and postoperative fasting for 6-8 hours. Group-B included 50 patients who were advised shorter fasting time; 6 hours for solid diet and until 2 hours for liquid diet before and after operation.

Results: In Group-B patients almost all recovery indicators were better with lesser complications and shorter hospital stay as compared to patients of Group-A. There was saving of 1-2 IV fluid drips of 1000ml each, per patient which reduced the cost of treatment, nursing services load and financial burden over Hospital.
Conclusion: Lesser fasting time allowing liquid diet until 2 hours before and after operation under GA/SAB was more beneficial than traditional NPO after midnight before & for 6-8 hours after operation. It was safe, cost effective & significantly reduced recovery time and hospital stay. Hospitals, anesthetists and surgeons are recommended to adopt this new protocol.