Patients Fasting Too Long before surgery

[Guest guest]

Study: Patients Fasting Too Long

Mon May 6, 1:02 AM ET

By SUSAN PARROTT, Associated Press Writer

DALLAS (AP) - Despite liberalized guidelines that shorten pre-operation

fasting times, many patients undergoing elective surgery still are

instructed to go without food and liquids for excessive periods,

according to a new study.

Some patients fasted for 20 or more hours before going under anesthesia

and suffered from irritability, severe hunger, headaches, dehydration

and lowered blood sugar, the study found.

" Obviously this isn't good for patients, " said Jeannette Crenshaw,

co-author of the study published in the May issue of the American

Journal of Nursing.

Most of 155 patients interviewed after surgery said they were told not

to ingest anything after 12 a.m. on the day of surgery, which the

American Society of Anesthesiology no longer believes is necessary for

most patients undergoing elective surgery.

In 1999, the ASA released new guidelines allowing clear liquids, such as

black coffee, tea, apple juice or carbonated beverages, up to two hours

before elective surgery, a light breakfast such as tea and toast six

hours before the procedure, and a heavier meal if the surgery is eight

hours away.

Crenshaw said shortened fasts generally do not increase the risk of

vomiting during surgery, or the incidence of pulmonary aspiration, a

rare and sometimes fatal complication in which stomach contents enter

the lungs.

The researchers interviewed patients at Presbyterian Hospital in Dallas

at the end of 2001 and early this year. On average, the patients

refrained from consuming liquids for 12 hours and solids for 14 hours.

One patient had nothing to drink for as long as 20 hours and two

patients went without food for 37 hours.

Mason, a registered nurse and editor-in-chief of the American

Journal of Nursing, said there is often a lag between the release of

published guidelines on patient care and their implementation.

" Hospitals need to change the status quo and initiate fasting policies

that are congruent with, in this case, the ASA recommendations, " she

said.

Crenshaw said Presbyterian Hospital is revising its fasting policy to

include the ASA guidelines, which apply only to healthy patients

undergoing elective surgery.

Some hospitals have feared that relaxing fasting guidelines would impair

their flexibility to schedule surgeries, said Dr. Mark Warner, chair of

anesthesiology at the Mayo Clinic in Rochester, Minn.

But operations are more likely to be delayed than to be rescheduled for

much earlier than originally set, he said.

And consuming clear liquids several hours before surgery helps flush out

acids from the stomach, Warner said. In addition, a cup of black coffee

or tea will help some people avoid headaches and nausea caused by

caffeine withdrawal.

Ray Thibodeau fasted from food and liquids for more than 20 hours when

he had cataract surgery, which was unexpectedly delayed from about 8

a.m. to 4 p.m.

" I was clearly not suffering malnutrition, " said the Doylestown, Pa.,

man. " But the mental process takes over. I could have eaten the back

side of a mule, I was so hungry. "

He said some liquids the day of the surgery would have eased his

discomfort.

[Guest guest]

a,

This is good before my surgery I had to stop eating two days before. Only

clear liquids for those days and nothing the day of the surgery. I think

though I was too scared to care at that point. I also had to drink a

preparation to clean everything out two days before, which kept me up at

night. At the time I thought it was so wrong to make someone drink

something that would work like that. I was so tired the day of the

surgery. Good article,

Lynn (MeMom)

----------

> From: a <paula54@...>

> < >

> Cc: psoriaticArthritis

> Subject: [ ] Patients Fasting Too Long before surgery

> Date: Monday, May 06, 2002 10:48 AM

>

> Study: Patients Fasting Too Long

> Mon May 6, 1:02 AM ET

>

> By SUSAN PARROTT, Associated Press Writer

>

> DALLAS (AP) - Despite liberalized guidelines that shorten pre-operation

> fasting times, many patients undergoing elective surgery still are

> instructed to go without food and liquids for excessive periods,

> according to a new study.

>

> Some patients fasted for 20 or more hours before going under anesthesia

> and suffered from irritability, severe hunger, headaches, dehydration

> and lowered blood sugar, the study found.

>

> " Obviously this isn't good for patients, " said Jeannette Crenshaw,

> co-author of the study published in the May issue of the American

> Journal of Nursing.

>

> Most of 155 patients interviewed after surgery said they were told not

> to ingest anything after 12 a.m. on the day of surgery, which the

> American Society of Anesthesiology no longer believes is necessary for

> most patients undergoing elective surgery.

>

> In 1999, the ASA released new guidelines allowing clear liquids, such as

> black coffee, tea, apple juice or carbonated beverages, up to two hours

> before elective surgery, a light breakfast such as tea and toast six

> hours before the procedure, and a heavier meal if the surgery is eight

> hours away.

>

> Crenshaw said shortened fasts generally do not increase the risk of

> vomiting during surgery, or the incidence of pulmonary aspiration, a

> rare and sometimes fatal complication in which stomach contents enter

> the lungs.

>

> The researchers interviewed patients at Presbyterian Hospital in Dallas

> at the end of 2001 and early this year. On average, the patients

> refrained from consuming liquids for 12 hours and solids for 14 hours.

> One patient had nothing to drink for as long as 20 hours and two

> patients went without food for 37 hours.

>

> Mason, a registered nurse and editor-in-chief of the American

> Journal of Nursing, said there is often a lag between the release of

> published guidelines on patient care and their implementation.

>

> " Hospitals need to change the status quo and initiate fasting policies

> that are congruent with, in this case, the ASA recommendations, " she

> said.

>

> Crenshaw said Presbyterian Hospital is revising its fasting policy to

> include the ASA guidelines, which apply only to healthy patients

> undergoing elective surgery.

>

> Some hospitals have feared that relaxing fasting guidelines would impair

> their flexibility to schedule surgeries, said Dr. Mark Warner, chair of

> anesthesiology at the Mayo Clinic in Rochester, Minn.

>

> But operations are more likely to be delayed than to be rescheduled for

> much earlier than originally set, he said.

>

> And consuming clear liquids several hours before surgery helps flush out

> acids from the stomach, Warner said. In addition, a cup of black coffee

> or tea will help some people avoid headaches and nausea caused by

> caffeine withdrawal.

>

> Ray Thibodeau fasted from food and liquids for more than 20 hours when

> he had cataract surgery, which was unexpectedly delayed from about 8

> a.m. to 4 p.m.

>

> " I was clearly not suffering malnutrition, " said the Doylestown, Pa.,

> man. " But the mental process takes over. I could have eaten the back

> side of a mule, I was so hungry. "

>

> He said some liquids the day of the surgery would have eased his

> discomfort.

>

>

>

[Guest guest]

Lynn,

The kind of surgery you had required the type of fasting you had to go

through.

I know how unpleasant it was, but it's necessary to be completely empty

for abdominal surgery.

The standard " no eating after midnight " for many procedures is to rigid

and not good for

everyone especially if the surgery is later in the afternoon. I never

understood why plain

water wasn't allowed up to a few hours before the surgery. I'm glad

they are considering

revising their stand on this.

Hope you are feeling well.

a

On Tuesday, May 7, 2002, at 08:43 AM, Ruf-Caimi wrote:

> a,

>       This is good before my surgery I had to stop eating two days

> before.  Only

> clear liquids for those days and nothing the day of the surgery.  I

> think

> though I was too scared to care at that point.  I also had to drink a

> preparation to clean everything out two days before, which kept me up at

> night.  At the time I thought it was so wrong to make someone drink

> something that would work like that.  I was so tired the day of the

> surgery.  Good article,

> Lynn (MeMom)