- 期刊
Fasting leads to fasting: examining the relationships between perioperative fasting times and fasting for symptoms in patients undergoing elective abdominal surgery
摘要
Background and Objectives: A growing body of evidence indicates traditional perioperative care practices of extended fasting and delayed feeding are outdated and detrimental to patient prognosis. This study aimed to explore associations between perioperative fasting, progression to solids and fasting for symptoms; assessing whether excessive pre-operative fasting results in further fasting post-operatively. Methods and Study Design: Two hundred patients who underwent elective surgery from March 2015 to June 2015 in upper gastrointestinal, colorectal and urological departments of a major teaching hospital were included in the study. A retrospective medical record audit was conducted to determine patient demographics, clinical data, perioperative fasting times and diet progression. Results: Preoperative fasting significantly correlated with time taken to progress to solids (rs(198)=0.180, p=0.011), but not with postoperative fasting. Patients who experienced subsequent fasting episodes for symptom management had a significantly longer postoperative fasting time (Med=25.5 hours +/- 19.7) than those who did not (Med=6.2 hours +/- 38.7, p=0.025). Significant differences in fasting times and diet progression were found based on Enhanced Recovery After Surgery (ERAS) status, magnitude of surgery, surgical department, and morning versus afternoon operating lists. Conclusions: Associations between extended perioperative fasting times, diet progression, and fasting for symptoms exist, such that the adverse effects of suboptimal nutritional status on recovery may be traced back to before the patient even arrives for surgery. Challenges of reducing fasting times may be overcome with repeated training of clinicians with best practice guidelines, and improving postoperative adherence to ERAS protocols.
延伸閱讀
- 黃慧珍、方素瓔（2016）。A Systematic Review of the Literature Related to Elevating the Head of the Bed for Patients With Gastroesophageal Reflux Disease: Applications in Patients After Esophageal Cancer Surgery。護理雜誌，63(3)，83-93。https://doi.org/10.6224/JN.63.3.83
- Gade, H., Hjelmesæth, J., Rosenvinge, J. H., & Friborg, O. (2014). Effectiveness of a Cognitive Behavioral Therapy for Dysfunctional Eating among Patients Admitted for Bariatric Surgery: A Randomized Controlled Trial. Journal of Obesity, (2014), a1-6. https://doi.org/10.1155/2014/127936
- Siaw, M. Y. L., Chew, D. E. K., Dalan, R., Shakoor, S. A. K. K. A., Othman, N., Choo, C. H., Shamsuri, N. H., Karim, S. N. A., Chan, S. Y., & Lee, J. Y. C. (2014). Evaluating the Effect of Ramadan Fasting on Muslim Patients with Diabetes in relation to Use of Medication and Lifestyle Patterns: A Prospective Study. International Journal of Endocrinology, 2014(), 487-492-051. https://doi.org/10.1155/2014/308546
- Zeng, L., Li, H. R., Liu, M. W., Rao, W. M., & He, Q. Q. (2022). Effects of intermittent fasting on cardiometabolic risk factors in patients with metabolic syndrome: A systematic review and meta-analysis of randomized controlled trials. Asia Pacific Journal of Clinical Nutrition, 31(4), 642-659. https://doi.org/10.6133/apjcn.202212_31(4).0008
- Zeng, L., Li, H. R., Liu, M. W., Rao, W. M., & He, Q. Q. (2013). Effects of intermittent fasting on cardiometabolic risk factors in patients with Metabolic syndrome: A systematic review and meta-analysis of randomized controlled trials. Asia Pacific Journal of Clinical Nutrition, (), 1-33. https://doi.org/10.6133/apjcn.202211/PP.0008