Furrer L, Ganter M T, Klaghofer R, Zollinger A, Hofer C K
Institut für Anästhesiologie und Intensivmedizin, Stadtspital Triemli, Birmensdorferstrasse 497, 8063 Zürich.
Anaesthesist. 2006 Jun;55(6):643-9. doi: 10.1007/s00101-006-0991-x.
In order to improve perioperative subjective quality of care it seems desirable to shorten preoperative fasting times as much as possible within acceptable safety limits. These efforts should result in a measurable reduction of preoperative thirst and hunger as well as in improvements of patient well-being. It is unknown to what extent preoperative patient comfort is limited by thirst and hunger from a patient point of view. The purpose of this study was to determine the impact of a traditional fasting regimen on preoperative patient discomfort.
We conducted a survey on preoperative thirst and hunger in 412 adult American Society of Anesthesiologists ASA I and II patients scheduled for minor elective surgery.
Of the patients 33% complained of moderate to strong thirst, whereas 19% had moderate to strong hunger, 47% of the participants would have liked to have been able to drink and 72% would have appreciated a light breakfast before surgery. Mean preoperative fasting times were 12.8+/-3.4 h for fluids and 15.5+/-4.4 h for solids. "Thirst" was named by 3.3% and "hunger" by 0.8% of patients as the most important factor for preoperative discomfort but "long wait" (8.5%), "tenseness" (6.5%) and "anxiety" (4.8%) were the most frequently named factors. Answers were independent of the duration of preoperative fasting.
Patient comfort is compromised by traditional fasting rules and liberalization of these policies is desired by patients. However, efforts to reduce preoperative anxiety and tenseness might have an additional, important potential to improve perioperative quality of care from a patient's perspective.
为了提高围手术期的主观护理质量，在可接受的安全范围内尽可能缩短术前禁食时间似乎是可取的。这些措施应能显著减轻术前口渴和饥饿感，并改善患者的舒适度。从患者的角度来看，术前口渴和饥饿在多大程度上限制了患者舒适度尚不清楚。本研究的目的是确定传统禁食方案对术前患者不适的影响。
我们对412例计划接受小型择期手术的美国麻醉医师协会（ASA）I级和II级成年患者进行了术前口渴和饥饿情况的调查。
33%的患者抱怨有中度至强烈的口渴感，19%的患者有中度至强烈的饥饿感，47%的参与者希望能够饮水，72%的患者希望在手术前吃一顿清淡的早餐。术前平均禁食时间为：液体12.8±3.4小时，固体15.5±4.4小时。3.3%的患者将“口渴”和0.8%的患者将“饥饿”列为术前不适的最重要因素，但“等待时间长”（8.5%）、“紧张”（6.5%）和“焦虑”（4.8%）是最常被提及的因素。答案与术前禁食时间无关。
传统的禁食规则会损害患者舒适度，患者希望放宽这些政策。然而，从患者的角度来看，努力减轻术前焦虑和紧张情绪可能对提高围手术期护理质量具有额外的重要潜力。
