scholarly journals Adjustment of Preoperative Fasting Guidelines for Adult Patients Undergoing Elective Surgery

2015 ◽  
Vol 05 (04) ◽  
pp. 115-118 ◽  
Author(s):  
Eissa Bilehjani ◽  
Solmaz Fakhari ◽  
Samira Yavari ◽  
Jafar Rahimi Panahi ◽  
Mohammadreza Afhami ◽  
...  
Keyword(s):  
Elective Surgery ◽  
Adult Patients ◽  
Preoperative Fasting

scholarly journals Preoperative Fasting among Adult Patients for Elective Surgery in a Kenyan Referral Hospital

2017 ◽  
Vol 2017 ◽  
pp. 1-8 ◽  
Author(s):  
George Njoroge ◽  
Lucy Kivuti-Bitok ◽  
Samuel Kimani
Keyword(s):  
Elective Surgery ◽  
Cross Sectional Study ◽  
Adult Patients ◽  
Mirror Reflection ◽  
Preoperative Fasting ◽  
Sectional Study ◽  
National Hospital ◽  
Cross Sectional ◽  
Ethical Approval

Background. Preoperative fasting (POF) is physiologically and precautionary important during anesthesia and surgery. POF from midnight has been practiced despite the recommended shorter practice. Objective. Assessing preoperative fasting among adult patients scheduled for elective surgery at Kenyatta National Hospital (KNH). Methods. A descriptive cross-sectional study involving 65 surgical patients. A questionnaire of mixed questions on demographics, reasons, source of instructions, opinion on instructions, time, premedication practices, outcome, and complains on NPO was used. Analysis was quantitatively done with SPSS v. 22. Ethical approval was obtained from KNH-UoN ERC. Results. Of the respondents 93.8% lacked knowledge on the correct reasons for POF and felt that the instructions were unclear and less important <50%. POF instructions were administered by nurses 80%, anesthetists 15%, and surgeons 5%. Most of respondents (73.8%) fasted > 15 hours. The POF outcomes were rated moderately challenging as follows: prolonged wait for surgery 44.6%, thirst 43.1%, hunger 36.9%, and anxiety 29.2%. Conclusion. Nurses are critical in providing POF instructions and care, and patient knowledge level is a mirror reflection of the quality of interventions. This underscores the need to build capacity for nurses and strengthen the health system to offer individualized preoperative interventions as well as monitoring and clinical auditing of fasting practices.

An exploration of pre-operative fasting practices in adult patients having elective surgery

2020 ◽  
Vol 29 (7) ◽  
pp. 436-441
Author(s):  
Lovejoy Denkyi
Keyword(s):  
Health Professionals ◽  
Elective Surgery ◽  
International Perspective ◽  
Gastric Volume ◽  
Adult Patients ◽  
Cochrane Central Register ◽  
Preoperative Fasting ◽  
Central Register ◽  
Fasting Time ◽  
New Guidelines

Background: Patients fast routinely before elective surgery in order to reduce gastric volume and acidity. The standard fasting time is ‘nil by mouth’ from midnight before surgery. In recent years, new guidelines have recommended that patients remain nil by mouth from clear fluids for 2 hours and from solids for 6 hours. This literature review explored preoperative fasting practices in adult patients from an international perspective. Methods: A literature search was undertaken of databases, including CINAHL Plus, PubMed, Medline, the Cochrane Central Register of Controlled Trials, Science Direct, Sage Journals and Embase. Results: Anaesthetists were found to possess greater knowledge of reduced preoperative fasting than other health professionals including nurses. Conclusion: Actual fasting time was found to be relatively longer than prescribed fasting times.

scholarly journals The semisitting position: analysis of the risks and surgical outcomes in a contemporary series of 425 adult patients undergoing cranial surgery

2017 ◽  
Vol 127 (4) ◽  
pp. 867-876 ◽  
Author(s):  
Andrea Saladino ◽  
Massimo Lamperti ◽  
Antonella Mangraviti ◽  
Federico G. Legnani ◽  
Francesco U. Prada ◽  
...  
Keyword(s):  
Neurological Outcome ◽  
Elective Surgery ◽  
Air Embolism ◽  
Adult Patients ◽  
Consecutive Series ◽  
Related Complication ◽  
Venous Air Embolism ◽  
Significant Statistical Difference ◽  
Increased Risk ◽  
Additional Option

OBJECTIVEThe objective of this study was to analyze the incidence of the primary complications related to positioning or surgery and their impact on neurological outcome in a consecutive series of patients undergoing elective surgery in the semisitting position.METHODSThe authors prospectively collected and retrospectively analyzed data from adult patients undergoing elective surgery in the semisitting position for a cranial disease. Patients were managed perioperatively according to a standard institutional protocol, a standardized stepwise positioning, and surgical maneuvers to decrease the risk of venous air embolism (VAE) and other complications. Intraoperative and postoperative complications were recorded. Neurointensive care unit (NICU) length of stay (LOS) and hospital LOS were the intermediate endpoints. Neurological outcome was the primary endpoint as determined by the modified Rankin scale (mRS) score at 6 months after surgery.RESULTSFour hundred twenty-five patients were included in the analysis. VAE occurred in 90 cases (21%) and it made no significant statistical difference in NICU LOS, hospital LOS, and neurological outcome. No complication was directly related to the semisitting position, although 46 patients (11%) experienced at least 1 surgery-related complication and NICU LOS and hospital LOS were significantly prolonged in this group. Neurological outcome was significantly worse for patients with complications (p < 0.0001).CONCLUSIONSEven in the presence of intraoperative VAE, the semisitting position was not related to an increased risk of postoperative deficits and can represent a safe additional option for the benefit of specific surgical and patient needs.

scholarly journals Perioperative Risk Factors for Intraoperative Hypothermia in Adult Patients Undergoing Elective Surgery at a National Referral Hospital in Bhutan: A Prospective Observational Study

2019 ◽  
Author(s):  
Kinley Zangmo ◽  
Sunisa Chatmongkolchart ◽  
Pasuree Sangsupawanich
Keyword(s):  
Risk Factors ◽  
Heart Rate ◽  
Observational Study ◽  
Prospective Observational Study ◽  
Elective Surgery ◽  
Perioperative Risk ◽  
Referral Hospital ◽  
Adult Patients ◽  
Intraoperative Hypothermia ◽  
National Referral Hospital

Objective: Intraoperative hypothermia is commonly encountered in anesthetic practice. It is related to several risk factors and can lead to various adverse events. It is important to detect it early and prevent the complications related to it. This study was done to identify incidence and perioperative risk factors of intraoperative hypothermia at a national referral hospital in Bhutan.Material and Methods: A prospective observational study was conducted in adult patients who underwent elective surgery lasting more than 30 minutes. Patient characteristics, incidence of hypothermia, and any interventions for treatment of hypothermia during the operation were recorded. Intraoperative hypothermia was defined as a core body temperature less than 36 °C measured with an esophageal probe.Results: Data were obtained from 91 patients with a mean (±standard deviation; S.D.) age of 42.3 (17.2) and American Society of Anesthesiologists (ASA) scores of 1 and 2 in 62.6% and 37.4% of the patients, respectively The patients underwent elective surgery with a mean (S.D.) duration of 73.24 (48.1) minutes and a mean (S.D.) duration of anaesthesia of 80.9 (49.2) minutes. The incidence of intraoperative hypothermia was 61.5% (56/91). Preoperative heart rate more than 80 beats per minute [hazard ratio (HR) 0.45, 95% confidence interval (CI), 0.26-0.77] was a protective factor and duration of anesthesia more than 60 minutes (HR 1.82, 95% CI, 0.98–3.38) was a risk factor for intraoperative hypothermia.Conclusion: Patients with a preoperative heart rate less than 80 beats per minute and undergoing duration of anesthesia more than 60 minutes should be assessed from the preoperative period and continuously monitored throughout the intraoperative period.

Surgical Alternatives in the Treatment of Intestinal Intussusceptions Resulting from Polyps in Adults

2013 ◽  
Vol 79 (9) ◽  
pp. 933-938
Author(s):  
Zulfu Arikanoglu ◽  
Akin Onder ◽  
Fatih Taskesen ◽  
Ibrahim Aliosmanoglu ◽  
Mesut Gul ◽  
...  
Keyword(s):  
Small Intestine ◽  
Elective Surgery ◽  
En Bloc Resection ◽  
Bloc Resection ◽  
Adult Patients ◽  
Segmental Resection ◽  
Adult Intussusception ◽  
En Bloc ◽  
Uncommon Disease ◽  
Benign Nature

Adult intussusception is an uncommon disease requiring surgical intervention. The aim of this study is to discuss the surgical alternatives and share our experience in the treatment of adult patients with intussusceptions formed as a result of polyps. The retrospective study included 16 adult patients who underwent surgery after the diagnosis of intestinal invaginations resulting from polyps between the years 2000 and 2011. Sixteen patients (seven males and nine females; mean age, 48.18 years; range, 18 to 76 years) presented with intestinal intussusceptions. Although a preoperative diagnosis was carried out in 11 (68.75%) patients, the diagnosis was made intra-operatively in five patients (31.25%). Among the patients, seven (43.8%) had undergone emergency surgeries and nine (52.8) had elective surgery. The invagination in 12 patients (75%) was located in the small intestine, in two patients (12.5%) in the colon, and in a further two patients (12.5%), it was ileocecally located. Ten patients (62.5%) had segmental resection 1 anastomosis; three patients underwent (18.8%) segmental resection 1 enterostomy, and three (18.8%) received hemicolectomies. In adults, surgical treatment is always the primary option in intussusceptions resulting from polyps. Although the surgical method of choice in colonically located ones is en bloc resection without reduction, because the polyps located in the small intestine are usually of a benign nature, segmental resection with reduction should be performed in elective surgery and segmental resection without reduction should be performed in emergency cases.

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