Preoperative Fasting Times for Patients Undergoing Caesarean Delivery: Before and After a Patient Educational Initiative

Özet

Objective: Prolonged preoperative fasting may lead to dehydration, hypoglycaemia, ketoacidosis and delayed recovery. We hypothesised that apatient educational initiative would decrease our preoperative fasting periods for elective caesarean delivery.Methods: This was an observational quality improvement impact study. Elective caesarean patients who delivered during our study period wereincluded in the study, 40 patients in the pre-intervention and 40 patients in the post-intervention groups. Only English-speaking patients wereincluded. We developed a patient educational pamphlet outlining preoperative fasting and analgesic expectations for caesarean delivery that wasgiven to every patient at her preoperative anaesthesia consultation. The pamphlet included the American Society of Anesthesiologists’ preoperative fasting and enhanced recovery carbohydrate drink recommendations. The primary outcome measure was intended fasting duration forliquids (defined as time from last reported liquid consumption to scheduled caesarean delivery) before and after the patient educational initiative.Secondary outcomes included solid fasting time, types of liquids and solids consumed.Results: The intended median (interquartile range) fasting time for liquids decreased from 10 (8.9-12) h to 3.5 (2.5-10) h (p<0.001). The fastingperiod for solids was not significantly different: 12.5 (10.5-14) h pre- versus 12.4 (10.6-14) h post-pamphlet introduction (p=0.384). Despite therecommendation, only 22.5% consumed a carbohydrate-containing drink with a modest decrease in water consumption (87.5% before and67.5% after; p=0.009).Conclusion: A patient educational pamphlet significantly reduced fasting time for clear liquids. Future studies are needed to determine whatbarriers limited adherence to the recommended carbohydrate-containing drink consumption.