Traditional Versus Instructing Standard Guidelines of Preoperative Fasting Times on Associated Discomforts in Patients undergoing Elective Cesarean Section: Orotta Maternity National Referral and Teaching Hospital and Sembel Hospital, Eritrea

  • Abstract
  • Keywords
  • References
  • Untitled
  • Abstract


    Introduction: Preoperative fasting is vital in preventing pulmonary aspiration, regurgitation and vomiting during the induction of anesthesia. Every patient scheduled for surgery including pregnant mothers need to be on fasting for certain period of time. Women undergoing cesarean section need full energy for themselves and the fetus to overcome the stress of birth. However, fasting time in Eritrea is generally longer than is recommended by American Society of Anesthesiologists. Prolonged fasting time has undesirable effects including, nausea, vomiting, dizziness, thirst, hunger etc. Objectives: This study compared the associated discomforts between traditional versus instructing standard guidelines of fasting times among mothers undergoing elective cesarean section. Methods: A non-randomized clinical trials among 106 mothers was conducted. Two groups for comparisons in two different hospitals were selected. One group received instructions of preoperative fasting according to the American Society of Anesthesiologists Task Force guidelines and the other group followed through the traditional approaches, i.e. “nothing by mouth after mid-night”. Results: Mild to moderate degrees of discomforts was seen in the study participants. Feelings of thirst and hunger were the serious discomforts experienced. The associated discomforts were not determined to be significantly different (p=0.256) among the two groups of comparison. Conclusion: The study concluded that the associated discomforts were not statistically different between the traditional and standard groups. There was mild to moderate degrees of discomforts in both groups of study. Though the finding shows similar magnitude of discomforts between the two comparison groups, postoperative discomforts appear to worsen as the timing of fasting increases.

  • References


      Abebe W.A., Rukewe A., Bekele N.A., & Stoffel M. (2015). Preoperative fasting times in elective surgical patients at a referral Hospital in Botswana. The Pan African Medical Journal.23:102. Doi:10.11604/pamj.2016.23.102.8863.

      Anderson M. & Comrie R., (2009). Adopting preoperative fasting guidelines. AORN. 90(1), 73-80.

      Aroni P., do Nascimento L.A., & Fonseca L.F. (2012). Assessment strategies for the management of thirst in the post-anesthetic recovery room. Acta Paul Enferm. 25(4), 530-536.

      Asiye G., Isil I. A., Hulya U. & Birgul O.O. (2013). Assessment of Preoperative Fasting Time in Elective general Surgery.The Journal of Macro trends in Health and Medicine,vol 1.

      Blanchard J.C., (2012). Requirements for preoperative fasting. AORN J. 95(5), 661-664.

      Crenshaw J.T., (2011). Preopreative fasting: will the evidence ever be put into practice. AJN. 111(10), 38-43

      Crenshaw, J.T. & Winslow, E.H. (2002). Preoperative fasting: old habits die hard. AJN. 102(5), 36-44.

      Crenshaw J.T., & Winslow E.H. (2006). Actual versus instructed fasting times and associated discomforts in women having scheduled cesarean birth. Journal Obstetrics Gynecology Neonatal Nursing. 35:257-64.

      Cunningham F.G., Norman F., Gant K.J., Leveno L.C, Gilstrap J.C., & Hauth K.D.(2001). 21st ed. New York: McGrow-Hill; Medical publishing Division; Williams obstetrics; p.314

      De Costa, C., & Howar P., (2006). Cesarean section. Manual for doctors. North Queensland, Austria.

      Direkvand-Moghadam A., and Rezaeian M. (2012). Increased hydration of nulliparas in labor. International Journal Gynaecology Obstetrics. 118: 23-5. 39

      Dolgun E., Taşdemir N., Ter N., Yavuz M., (2011). Investigation of preoperative fasting times of surgical patients. Fırat Üniversitesi Sağ.Bil.Tıp Derg. 25(1), 11-15.

      Faria M.N., de Aguilar-Nascimento J.E., & Pimenta, O.S., (2009). Preoperative fasting of 2 hours minimizes insulin resistance and organic response to trauma after video-cholecystectomy: A randomized, controlled, clinical trial. World Journal Surgery. 33(6), 1158-1164.

      Njorege G., Kivuti-Bitok, L., & Kimani, S., (2017). Preoperative fasting among Adult Patients for Elective Surgery in a Kenyan Referral Hospital. Hindawi International Scholarily research Notices.

      Gorashi C., Ashori V., Aminzadeh F., & Mokhtari M. (2014). The effects of oral fluid intake an hour before cesarean section on regurgitation incidence. Iranian Journal of Nursing and Midwifery research. 19(4): 439-442.

      Gunawardhana A.I., (2012). Knowledge, attitudes and practice of preoperative fasting guidelines in the National Hospital of Sri Lanka. Sri Lankan Journal of Anaesthesiology. 20(2), 92-95.

      Gunther P. P., & José Eduardo de Aguilar-Nascimento. (2013). Prolonged Preoperative Fasting in Elective Surgical Patients: Why Should We Reduce It? American Society for Parenteral and Enteral Nutrition DOI: 10.1177/0884533613514277

      Gyte G.M., & Richens Y. (2006). Routime prophylactic drugs in normal labour for reducing gastric aspiration and its effects. Cochrane database System Rev. (3):CD005298.

      Helminen H., Viitanen H., & Sajanti J. (2009). Effect of preoperative intravenous carbohydrate loading on preoperative discomfort in elective surgery atients. European Journal Anaesthesiology. 26:123-7. 40

      Janda M., Scheeren T.W. and Noldge-Schomburg G.F. (2006). Management of pulmonary aspiration. Best Res Clin Anaesthesiol. 20:09-27.

      Kapadia M., Kulshrestha M., Mathews J.J., & Sanwatsarkar S. (2013). Breaking the midnight fast: An observational cross-sectional audit of preoperative fasting policies and practices at a Tertiary Care Hospital. Indian Journal of Anaesthesia.Vol. 57, No. 4, July-August, 2013, pp. 414-417

      Katherine W. (2003). What are the benefits and pitfalls of reoperative fasting? Nursing Times. Vol:99, issue:50, no:32

      Levy D. M., & Webster V.L. (2004). Unrestricted sip of water before cesarean section. British Journal of Anesthesia.

      Ljungqvist O., & Soreide E. (2003). Preoperative fasting. British Journal of Surgery. 90:400–6

      Lopez A.C., Tomas Braulio J., & Montero Benzo R. (2002). Preoperative fasting regimens and premedication to reduce the risk of pulmonary aspiration. Rev ESP Anestesiol Reanim. 49:314-23.

      Ludwig R.B., Paludo J., Fernandes D., & Scherer F., (2013). Lesser time of preoperative fasting and early postoperative feeding are safe. Arq Bras Cir Dig. 26(1), 54-58.

      Macdonald S., & Magil C.J. (2011) 14th ed. London: Bailliere Tindall; mayes midwifery. A textbook for midwives.

      Maltby R. (2000). Preoperative fasting guidelines. Update in Anesthesia. Journal of Anesthesia in developing countries: Vol:12

      Mackenzie M., Yentis S., Woolnough M., & Johnson M.(2010). Fasting periods and dehydration before elective cesarean section. Journal of the association of Anesthetists of Great Britain and Ireland.85:94-113 41

      Manchikanti L, et al. (2011) Preoperative fasting before interventional techniques: is it necessary or evidence-based? Pain Physician.14 (5):459-67.

      Pexe-Machado P.A., de Oliveira B.D., Dock-Nascimento D.B. & de Aguilar-Nascimento J.E. (2013). Shrinking preoperative fast time with maltodextrin and protein hydrolysate in gastrointestinal resections due to cancer. Nutrition. 29, 1054–1059.

      Protic A., Turina, D., & Matanic, D., (2010). Effect of preoperative feeding on gastric emptying following spinal anesthesia: a randomized controlled trial. German. 122, 50–53.

      Raidoo D.M., Rocke D.A., Brock-Utne J.G., Marszalek A., & Engelrecht, H.E. Critical volume for pulmonary acid aspiration: reappraisal in a primate model. British Journal of Anaesthesia 1990; 65: 248-50

      Scarlett M., Crawford-sykes A., & Nelson M. (2002). Preoperative starvation and pulmonary aspiration. New perspectives and guidelines. West Indian medical Journal., 51:241-5.

      Tudor G., (2006). Fasting: how long is too long. Australian Nursing Journal. 13(7), 29-31.

      Warner M.A., Caplan R.A., Epstein, B.S. (1999). Task Force on preoperative fasting. Practice guidelines for preoperative fasting and the use of pharmacologic agents to reduce the risk of pulmonary aspiration: Application to healthy patients undergoing elective procedures: A report by the American Society of Anesthesiologist Task Force on Preoperative Fasting. Anesthesiology; 90: 896–905.

      Yagci G., Can M.F., Ozturk E. (2008). Effects of preoperative carbohydrate loading on glucose metabolism and gastric contents in patients undergoing moderate surgery: A randomized, controlled trial. Nutrition. 24(3), 212–216



Article ID: 26847
DOI: 10.14419/ijans.v7i2.26847

Copyright © 2012-2015 Science Publishing Corporation Inc. All rights reserved.