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术前禁食时间与私立综合医院手术患者临床结局的关系。

Association between preoperative fasting time and clinical outcomes in surgical patients in a private general hospital.

机构信息

Universidade Federal do Rio de Janeiro - Instituto de Nutrição Josué de Castro - Departamento de Nutrição e Dietética - Rio de Janeiro (RJ) - Brazil.

出版信息

Acta Cir Bras. 2024 Aug 16;39:e394524. doi: 10.1590/acb394524. eCollection 2024.

Abstract

PURPOSE

Surgical patients are routinely subjected to long periods of fasting, a practice that can exacerbate the metabolic response to trauma and impair postoperative recovery. The aim of this study was to evaluate the association between preoperative fasting time and clinical outcomes in surgical patients.

METHODS

An observational, prospective study with a non-probabilistic sample that included patients of both sexes, aged over 18, undergoing elective surgeries. Data were extracted from electronic medical records, and a questionnaire was applied in 48 hours after surgery. Variables related to postoperative discomfort were assessed using an 11-point numeric rating scale.

RESULTS

The sample consisted of 372 patients, and the duration of the surgical event ranged from 30-680 minutes. The incidence of nausea (26.34%) was twice that of vomiting (13.17%) and showed an association with the surgical procedure's size (p = 0.018). A statistically significant difference was observed only between pain intensity and preoperative fasting times for liquids (p = 0.007) and postoperative fasting time (p = 0.08). The occurrence of postoperative complications showed no association with preoperative fasting time (p = 0.850).

CONCLUSIONS

Although no association was observed between preoperative fasting time and surgical complications, it is noteworthy that both recommended and actual fasting time exceeded the proposed on clinical guidelines.

摘要

目的

外科患者通常需要长时间禁食,这种做法可能会加剧创伤后的代谢反应,并影响术后恢复。本研究旨在评估外科患者术前禁食时间与临床结局之间的关系。

方法

这是一项观察性、前瞻性研究,采用非概率抽样方法,纳入了 18 岁以上接受择期手术的男女患者。从电子病历中提取数据,并在术后 48 小时内应用问卷调查。使用 11 点数字评分量表评估与术后不适相关的变量。

结果

样本包括 372 名患者,手术时间从 30 分钟到 680 分钟不等。恶心的发生率(26.34%)是呕吐的两倍(13.17%),且与手术规模有关(p=0.018)。仅在液体术前禁食时间(p=0.007)和术后禁食时间(p=0.08)与疼痛强度之间观察到统计学显著差异。术后并发症的发生与术前禁食时间无相关性(p=0.850)。

结论

尽管术前禁食时间与手术并发症之间未观察到相关性,但值得注意的是,建议和实际禁食时间均超过了临床指南的规定。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5355/11328893/74b2e5f3ff78/1678-2674-acb-39-e394524-gf01.jpg

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