Beyond Guidelines: The Persistent Challenge of Preoperative Fasting Times

Abstract

Despite the advancements in evidence-based medicine, many hospitals still maintain high rates of patients undergoing prolonged preoperative fasting. The goal of this study is to determine the prevalence of prolonged fasting time among patients undergoing elective surgeries at a Brazilian university hospital and its associations with clinical and sociodemographic variables. This cross-sectional study was conducted between May and November 2019 and included patients of all ages undergoing elective surgeries. Out of the 293 patients analyzed, 64.2% were male, with ages ranging from 1 to 85 years, and 93.9% were classified as ASA I or II. The prevalence of preoperative fasting exceeding 8 h was 89.4%. An average fasting time exceeding 11 h was observed across all age groups. Patients who underwent procedures in the afternoon had an average fasting time that was 24% longer than those in the morning period (14.9 vs. 12 h, p p p < 0.04) demonstrated a weak correlation with fasting time. Despite the international consensus on preoperative fasting time, our study demonstrated low adherence to current recommendations. Therefore, healthcare professionals should ensure the comprehension of fasting guidelines, and further studies should aim to identify effective solutions to mitigate prolonged fasting.

Keywords

• anesthesia
• perioperative care
• dehydration
• fasting
• pulmonary aspiration