术前禁食指南：我们现在在哪里？一家三级医院的当前实践中的发现。
Preoperative Fasting Guidelines: Where Are We Now? Findings From Current Practices in a Tertiary Hospital.
机构信息
Department of Anesthesiology, The Seventh Affiliated Hospital of Sun Yat-Sen University, Shenzhen City, People's Republic of China.
Department of Urology, The Seventh Affiliated Hospital of Sun Yat-Sen University, Shenzhen City, People's Republic of China.
出版信息
J Perianesth Nurs. 2021 Aug;36(4):388-392. doi: 10.1016/j.jopan.2020.09.002. Epub 2021 Mar 4.
PURPOSE
New evidence-based fasting guidelines have been published in recent years. However, while water and solid food fasting times before anesthesia are recommended to be 2 and 6 hours, respectively, these times are often longer in clinical practice. This study aimed to investigate the awareness and implementation of the fasting guideline recommendations among nurses and anesthesiologists, as well as evaluate the actual fasting durations in patients in a tertiary hospital.
DESIGN
A cross-sectional study was used.
METHODS
Questionnaires were designed to collect the knowledge of fasting time among registered anesthesiologists and nurses. Data on the instructed and actual fasting durations among patients scheduled for elective surgery were evaluated.
FINDINGS
Approximately half of the nurses indicated that solid food fasting durations were shorter than 6 hours or longer than 8 hours, and two-thirds indicated that clear fluid fasting durations were shorter than 2 hours or longer than 4 hours. However, in clinical practice, nurse-instructed fasting durations were longer than what they knew was optimal. The anesthesiologists also prescribed longer fasting durations than the minimum fasting duration recommended. The actual fasting durations of the patients were significantly longer than the nurse-instructed fasting durations for solid food (13.41 ± 2.64 vs 9.87 ± 2.20 hours, P < .001) and clear fluids (10.27 ± 3.67 vs 8.98 ± 2.90 hours, P < .001). The nurse-instructed durations were significantly longer than the anesthesiologist-instructed durations according to the statements of patients (9.87 ± 2.20 vs 9.00 ± 2.00 hours for solid food, P < .001; 8.98 ± 2.90 vs 6.15 ± 3.25 hours for clear fluids, P < .001).
CONCLUSIONS
Excessive fasting durations were observed among patients. Anesthesiologists and nurses must work together to ensure that updated fasting instructions are implemented in routine clinical practice.
目的
近年来，新的循证禁食指南已经发布。然而，尽管麻醉前建议水和固体食物的禁食时间分别为 2 小时和 6 小时，但在临床实践中，这些时间往往更长。本研究旨在调查护士和麻醉师对禁食指南推荐的知晓和实施情况，并评估三级医院患者的实际禁食时间。
设计
采用横断面研究。
方法
设计问卷收集注册麻醉师和护士对禁食时间的了解。评估择期手术患者的医嘱禁食时间和实际禁食时间。
结果
约一半的护士表示固体食物的禁食时间短于 6 小时或长于 8 小时，三分之二的护士表示清液的禁食时间短于 2 小时或长于 4 小时。然而，在临床实践中，护士指导的禁食时间长于他们认为的最佳禁食时间。麻醉师也开出了比建议的最短禁食时间更长的禁食时间。患者的实际禁食时间明显长于护士指导的固体食物禁食时间（13.41±2.64 与 9.87±2.20 小时，P<0.001）和清液禁食时间（10.27±3.67 与 8.98±2.90 小时，P<0.001）。根据患者的说法，护士指导的时间明显长于麻醉师指导的时间（固体食物为 9.87±2.20 与 9.00±2.00 小时，P<0.001；清液为 8.98±2.90 与 6.15±3.25 小时，P<0.001）。
结论
患者的禁食时间过长。麻醉师和护士必须共同努力，确保在常规临床实践中实施更新的禁食指导。
Zotero 插件