Panebianco A, Laforgia R, Volpi A, Punzo C, Vacca G, Minafra M, Di Salvo M, Pezzolla A
G Chir. 2020 Jan-Feb;41(1):84-93.
For several years the scientific anaesthesia societies declared a preoperative fast of 6 hours for solid foods and 2 hours for clear liquids before elective surgical interventions to be sufficient. The aim of this study is to identify the extent of the gap that exists between the preoperative fasting time required and that actually encountered in operating rooms.
The safety and clinical applicability of a reduction of the preoperative fasting time was investigated through the use of oral solutions enriched with maltodextrin and their effects on the pre- and postoperative well-being that this may have on patients who are candidates for elective abdominal surgery. The study was conducted in two successive phases (I and II) and patients divided into two groups (A and B).
Clinical practice is slow to change, in fact, in our study the duration of fasting was an average of 19 hours for solids and 13 hours for liquids. The duration of the fasting did not show differences in the various surgical departments, demonstrating that it is a transversal practice and is not only limited to abdominal surgery in which the utility of fasting would theoretically be greater. Among Group patients A, the fasting time for liquids was about 9 hours. This shows that the time is certainly shorter but not much different when compared to the fasting time for liquids in group B which was on average 14 hours. It is important how difficult it is to achieve good compliance from patients when trying to reduce the time of preoperative fasting based on scientific evidence that is now well established.
The use of carbohydrate-enriched drinks up to 2 hours after induction of anaesthesia appears to be a safe procedure. The use of these solutions reduces the catabolic response to surgery and contributes to maintaining a pre-operative state of well-being by reducing feelings of hunger and thirst and the state of preoperative anxiety.
多年来，科学麻醉学会宣称，在择期手术干预前，固体食物禁食6小时、清液禁食2小时就足够了。本研究的目的是确定所需的术前禁食时间与手术室实际遇到的禁食时间之间存在的差距程度。
通过使用富含麦芽糊精的口服溶液，研究缩短术前禁食时间的安全性和临床适用性，以及其对择期腹部手术患者术前和术后健康状况的影响。该研究分两个连续阶段（I和II）进行，患者分为两组（A组和B组）。
临床实践的改变很缓慢，事实上，在我们的研究中，固体食物的禁食时间平均为19小时，液体为13小时。禁食时间在各个外科科室没有差异，表明这是一种普遍做法，不仅限于理论上禁食作用更大的腹部手术。在A组患者中，液体的禁食时间约为9小时。这表明该时间肯定较短，但与B组液体禁食时间平均为14小时相比，差异不大。当基于现已确立的科学证据试图缩短术前禁食时间时，要使患者达到良好的依从性是多么困难，这一点很重要。
麻醉诱导后2小时内使用富含碳水化合物的饮料似乎是一种安全的做法。使用这些溶液可降低手术的分解代谢反应，并通过减少饥饿和口渴感以及术前焦虑状态，有助于维持术前的健康状态。
