ORIGINAL ARTICLES Audit of Preoperative Fasting for Elective General Surgeries in the Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria

West Afr J Med . 2023 Aug 28;40(8):786-791.

Abstract

Abstract  in English, French

Background: Despite overwhelming evidence in favour of a relaxed fasting protocol, the traditional practice of keeping patients nil per oral from midnight before the day of surgery for all elective operations still appears to hold sway in many practices.

Methods: A prospective study to evaluate the pattern of preoperative fasting among patients undergoing elective general surgical operations in the Department of Surgery, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria, was conducted between June and December 2020. Data obtained was analysed using the IBM SPSS Statistics for Windows, version 24, and presented as descriptive statistics in the form of frequencies and percentages.

Results: The mean prescribed fasting duration was 11.2 ± 2.4 hours. The mean actual fasting duration of 17.6 ± 13.1 hours was significantly longer than the mean prescribed fasting duration (p= <0.001). Eighty-nine percent of patients fasted for >12 hours before their surgical operations. Bowel surgeries had the longest actual fasting duration of 34.9 ± 27.5 hours, while ventral hernia repairs and superficial mass excisions had the shortest duration of 13.5 ± 0.7 hours. Surgeries performed after noon had the longest actual fasting duration compared to those performed before noon (21.5 ± 18.7 hours vs. 15.6 ± 8.6 hours). Ninety percent of respondents reported hunger score of>4 while fasting.

Conclusion: Preoperative fasting duration in our surgical unit remains long and conventional. The potential implications of this practice on patients' physiological status and surgical outcomes are strong enough to motivate a change.

Keywords: American Society of Anaesthesiologists (ASA); Hunger Score; Nil Per Oral (NPO); Overnight fasting; Prolonged fasting; Traditional fasting protocol.

A O Adesunkanmi ¹, A E Ubom ², C U Ndegbu ³, A M Olugbami ⁴, O I Aaron ^5 6, F O Wuraola ^1 7, O Olasehinde ^1 7