Preoperative Fasting Time and Selected Postoperative Outcomes among Patients Undergoing Abdominal Surgeries: Correlation Study

Abstract

Background: Prolonged preoperative fasting time had a negative impact on the recovery of the patient in the postoperative period. Aim of the study: was to determine the relationship between the preoperative fasting time and selected postoperative outcomes among patients undergoing abdominal surgeries at one of the University Hospitals Cairo-Egypt. Research question: What is the relationship between the preoperative fasting time and the selected postoperative outcomes (patients' blood glucose levels, blood pressure and vomiting frequency) among patients undergoing abdominal surgeries? Design: Descriptive-correlation design was utilized. Setting: The study was conducted on waiting areas of general surgery operating room at 2^nd and 3^rd floor in addition to the general surgical wards at one of the University Hospitals. Subjects: A convenience sample of 60 female & male adult patients with the following inclusion criteria: 1- undergoing abdominal surgeries, 2- have no diabetes or hypertension were recruited in the current study Tools: Two tools were utilized to collect data pertinent to the study; I- A semi-structured interview questionnaire, it contained two parts: 1: Demographic data 2: Surgical patient’s clinical data.  II - Postoperative outcomes data sheet: It included measurement of the three selected postoperative outcomes. Results: The current study findings revealed that nearly three quarters of the study sample fasted for longer than required time with a mean+ SD= 11.1 + 2.5 and more than two third of the study sample had waiting time between 3->6 hrs. There was a significance difference between pre-operative & post-operative, post-operative & baseline readings regarding the systolic blood pressure and between the baseline and the pre-operative diastolic blood pressure. There was a positive moderate correlation between the pre-operative fasting time and the post-operative blood glucose results r=0.41. Also, there was a strong correlation between baseline and preoperative blood glucose results r=0.77, while, There was no correlation  between frequency of vomiting post operatively and age, preoperative fasting time, waiting time, blood glucose, and blood pressure.  Conclusion: There was a correlation between preoperative fasting time and blood glucose level followed by blood pressure while no correlation with vomiting frequency postoperatively. Recommendations: Awareness of heath care team regarding updating evidence-based preoperative fasting guidelines, nurse should measure blood glucose level and blood pressure for the non-diabetic as well as the diabetic patients before the surgical procedure and further studies are needed to determine the optimal fasting time and its effect on postoperative outcomes.

Keywords: Preoperative fasting time, waiting time, abdominal surgery, blood glucose level, blood pressure, postoperative vomiting.