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

Objective A 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.Design Multicentre survey.Setting Fou...

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Main Authors: Qianqian Zhu, Lifei Lai, Lianghua Zeng, Zhijing Yang, Yingling Zheng
Format: Article
Language:English
Published: BMJ Publishing Group 2022-07-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/12/7/e060716.full
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author Qianqian Zhu
Lifei Lai
Lianghua Zeng
Zhijing Yang
Yingling Zheng
author_facet Qianqian Zhu
Lifei Lai
Lianghua Zeng
Zhijing Yang
Yingling Zheng
author_sort Qianqian Zhu
collection DOAJ
description Objective A 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.Design Multicentre survey.Setting Four tertiary hospitals in Shenzhen City, China.Participants A total of 988 patients completed a survey on instructed and actual postoperative fasting.Outcomes All 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).Results The 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.Conclusion Approximately 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.
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spelling doaj-art-77fe035f06034d7a993c31d51fca4dec2025-01-31T07:35:10ZengBMJ Publishing GroupBMJ Open2044-60552022-07-0112710.1136/bmjopen-2021-060716Current practice of postoperative fasting: results from a multicentre survey in ChinaQianqian Zhu0Lifei Lai1Lianghua Zeng2Zhijing Yang3Yingling Zheng4Department of Anesthesiology, The Seventh Affiliated Hospital of Sun Yat-sen University, Shenzhen, ChinaDepartment of Anesthesiology, The Seventh Affiliated Hospital of Sun Yat-sen University, Shenzhen, ChinaDepartment of Anesthesiology, Shenzhen Qianhai Shekou Free Trade Zone Hospital, Shenzhen, ChinaDepartment of Anesthesiology, Shenzhen University General Hospital, Shenzhen, ChinaDepartment of Anesthesiology, Integrated Traditional Chinese and Western Medicine Hospital, Shenzhen, ChinaObjective A 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.Design Multicentre survey.Setting Four tertiary hospitals in Shenzhen City, China.Participants A total of 988 patients completed a survey on instructed and actual postoperative fasting.Outcomes All 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).Results The 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.Conclusion Approximately 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.https://bmjopen.bmj.com/content/12/7/e060716.full
spellingShingle Qianqian Zhu
Lifei Lai
Lianghua Zeng
Zhijing Yang
Yingling Zheng
Current practice of postoperative fasting: results from a multicentre survey in China
BMJ Open
title Current practice of postoperative fasting: results from a multicentre survey in China
title_full Current practice of postoperative fasting: results from a multicentre survey in China
title_fullStr Current practice of postoperative fasting: results from a multicentre survey in China
title_full_unstemmed Current practice of postoperative fasting: results from a multicentre survey in China
title_short Current practice of postoperative fasting: results from a multicentre survey in China
title_sort current practice of postoperative fasting results from a multicentre survey in china
url https://bmjopen.bmj.com/content/12/7/e060716.full
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