Chon Telliane, Ma Alfred, Mun-Price Connie
Anesthesiology, Riverside University Health System, Moreno Valley, California, United States.
Cureus. 2017 May 24;9(5):e1272. doi: 10.7759/cureus.1272.
Standard preparation for a surgical procedure requires patients to fast (nulla per os [NPO]) after midnight before their operation. Unfortunately, given the unpredictable nature of operating room scheduling and unavoidable delays, patients may find themselves anxiously waiting and fasting much longer than expected. In recent years, the usefulness of prolonged fasting to prevent pulmonary aspiration has been questioned. According to the American Society of Anesthesiologists (ASA) guidelines, unnecessarily prolonged fasting can be avoided by allowing patients to have clear liquids with the minimal fasting time of only two hours. This study examines a random sampling of elective scheduled surgeries at a 439-bed safety-net teaching hospital in Southern California in October 2016. The study revealed significantly prolonged NPO times caused by delays in the scheduling of operation times. An analysis of delays revealed that prior surgical procedures running longer than scheduled were the most common reason for a delay in starting an operation and, subsequently, prolonging patient fasting time. Significantly prolonged fasting times warrant the need for institutional management strategy changes and a revamping of clinical education curriculums.
外科手术的标准准备要求患者在手术前一天午夜后禁食（禁食禁水 [NPO]）。不幸的是，鉴于手术室排班的不可预测性和不可避免的延误，患者可能会发现自己焦急地等待且禁食时间比预期长得多。近年来，长时间禁食以预防肺误吸的有效性受到了质疑。根据美国麻醉医师协会（ASA）的指南，通过允许患者饮用清液，最短禁食时间仅两小时，可避免不必要的长时间禁食。本研究调查了2016年10月在南加州一家拥有439张床位的安全网教学医院进行的择期手术的随机样本。研究显示，手术时间安排的延误导致禁食禁水时间显著延长。对延误情况的分析表明，先前的外科手术比预定时间持续更长是手术开始延迟以及随后延长患者禁食时间的最常见原因。显著延长的禁食时间有必要对机构管理策略进行调整，并对临床教育课程进行修订。
