Adherence to recommendations and real situation of preoperative fasting in elective surgery patients of a Lithuanian tertiary center
| Date | Volume | Issue | Start Page | End Page |
|---|---|---|---|---|
2025-06-01 | 42 | Suppl. 63 | 14 | 14 |
Abstract no. 10AP02-9
Background and Goal of Study : Current fasting guidelines state that no clear liquids should be consumed <2h, solid food <6h before surgery [1,2]. However, following guidelines is a problem. The aim of the study was to evaluate the situation in Lithuanian University of Health Sciences Hospital Kaunas Clinics (KC) in terms of awareness, real-time intake and possible adverse symptoms of dehydration. Materials and Methods: The anonymous survey study received ethical approval (No 2023-BEC2-263) and was performed at KC in 11.2023 – 10.2024. Adult consecutive Lithuanian speaking, mentally healthy and admitted for elective surgery in 24h patients were asked to fill an original questionnaire. Anaesthesiologists were asked to report intraoperative complications possibly related to fasting. Statistical analysis was performed with SPSS 29.0.0.0. Data is presented as mean±SD, number or % of cases. Results and Discussion: The study included 87 patients, 36 males and 51 females. Mean time of last intake before surgery was 10.82±5.72 h for fluid and 16.16±4.39 h for solid food. According to patients, fluids must not be taken preoperatively: <2h in 16(18.4%), <6h in 51(58.6%), <24h in 16(18.4%) and indefinitely in 4(4.6%) cases, respectively. Patients stated they knew the definition of clear fluids in 65(74.7%) cases but only 42(48.3%) of them marked the correct list of clear fluids. 79(90.8%) patients were informed about preoperative fluid intake: 52 by the surgeon, 35 - a resident doctor or another specialist, 29 - family doctor or nurse, 23 - an anaesthesiologist, 12
- relied on previous knowledge or social media. Complaints related to prolonged fasting were xerostomia (n=45), thirst (n=43), heart palpitations (n=19), headache (n=11), fatigue (n=7), dizziness (n=5), muscle cramps (n=4), nausea (n=2). Anaesthesiologists reported the following intraoperative adverse effects related to prolonged fasting: 7 cases of arterial hypotension, 3 cases requiring iv fluids and vasopressors and 1 case of bradycardia requiring atropine. Conclusions: Patient awareness of preoperative fasting is low: 18.4% of respondents define recommended intervals correctly. Mean duration of last oral intake exceeds the recommended interval by 5 times for clear fluids and 2.5 times - solid food. This leads to subjective and objective haemodynamic adverse effects of hypovolaemia.