#35875 Perioperative fluid fasting in elective upper limb surgery in a tretiary orthopaedic hospital

Rhys Williams, Mruthunjaya Hulgur
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Abstract

Please confirm that an ethics committee approval has been applied for or granted: Not relevant (see information at the bottom of this page) Application for ESRA Abstract Prizes: I don’t wish to apply for the ESRA Prizes

Background and Aims

Fasting guidelines have been established to reduce the risk of a pulmonary aspiration event in patients undergoing anaesthesia. Excessive fasting can contribute to anxiety, nausea, dehydration and physiological derangement. In practice, patients are likely to be fasted for longer than the conventional times. The aim of our project was to identify the average length of fluid fast in our elective patients.

Methods

This was a retrospective case-note review of 50 patients undergoing elective upper limb surgery in our tertiary orthopaedic institution. Their reported fasting times for solids and liquids were recorded. Their sent for operation times were interrogated from Operating Room Management Information System (ORMIS) computer system. This information was subsequently compiled into a datasheet.

Results

The average fasting time for solids was 14h 30mins. The average conventional fluid fasting time was 3h 29 mins. When this adjusted to a sent for operating time, the average time was 6 h 11min (range 0min to 18h 10 min). 16% of patients included in the study were fluid fasted for greater than 12 hours.

Conclusions

Our study revealed excessive fasting times in the majority of our patients. Evidently a two-hour fluid fasting target becomes a longer fast in the real world. We have adapted out current fasting guidelines to align with progressive institutions which use a sip-till-send approach to allow 170ml of water each hour until sent for operating (Checketts 2023). We will re-audit these times after implementation of the guideline.
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#35875三级骨科医院择期上肢手术围手术期禁食
请确认已申请或授予伦理委员会批准:不相关(见本页底部信息)ESRA申请摘要奖励:我不希望申请ESRA奖励背景和目的已经建立了禁食指南,以降低接受麻醉的患者肺部误吸事件的风险。过度禁食会导致焦虑、恶心、脱水和生理紊乱。实际上,患者的禁食时间可能比传统时间更长。我们项目的目的是确定我们的择期患者液体禁食的平均长度。方法回顾性分析我院三级骨科收治的50例选择性上肢手术患者。他们报告的固体和液体禁食时间被记录下来。通过手术室管理信息系统(ORMIS)计算机系统查询患者的手术时间。这些资料随后被汇编成一份数据表。结果固体禁食时间平均为14h 30min。常规液体禁食时间平均为3h 29 min。当此调整为发送操作时间时,平均时间为6小时11分钟(范围为0分钟至18小时10分钟)。研究中16%的患者液体禁食超过12小时。结论:我们的研究显示大多数患者空腹时间过长。显然,两个小时的液体禁食目标在现实世界中变得更长了。我们已经调整了目前的禁食指南,以与先进的机构保持一致,这些机构使用小口-直到送出的方法,每小时允许170毫升的水,直到送出操作(Checketts 2023)。我们将在指南实施后重新审核这些时间。
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