Current practice of postoperative fasting: results from a multicentre survey in China

Lifei Lai, Lianghua Zeng, Zhijing Yang, Yingling Zheng, Qianqian Zhu, Lifei Lai, Lianghua Zeng, Zhijing Yang, Yingling Zheng, Qianqian Zhu

Abstract

Objective: A gap between clinical practice and evidence is common. The present multicentre study was designed to explore the actual postoperative fasting practice, including the instructed fasting time from the ward staff and the actual postoperative fasting time.

Design: Multicentre survey.

Setting: Four tertiary hospitals in Shenzhen City, China.

Participants: A total of 988 patients completed a survey on instructed and actual postoperative fasting.

Outcomes: All patients received postoperative instructed fasting time from the ward staff. The median instructed fasting time for fluids from ward staff was 6 hours (IQR, 4-6 hours), and the median instructed fasting time for solid food was also 6 hours (IQR 5-6 hours) after surgery. The actual postoperative fasting time, including fluid and solid food intake, was significantly longer than the time recommended by the ward staff (both p<0.001).

Results: The median time to postoperative first flatus (FFL) was 16.5 hours (IQR 8-25.5 hours), and the median time to postoperative first faeces (FFE) was 41 hours (IQR 25-57 hours). The fasting time was significantly shorter than the time to FFL and the time to FFE, regardless of surgery type or anaesthesia type (all p<0.001). Postoperative nausea and vomiting (PONV) occurred in 23.6% of patients. After surgery, 58.70% of patients reported thirst, and 47.47% reported hunger. No ileus occurred.

Conclusion: Approximately half of the patients reported thirst and hunger postoperatively. Patients initiated oral intake earlier than the time to FFL or FFE without increasing serious complications. This study may support the rationale for interventions targeting postoperative oral intake time in future studies.

Keywords: adult anaesthesia; adult surgery; nutritional support.

Conflict of interest statement

Competing interests: None declared.

© Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

Figures

Figure 1
Figure 1
The instructed and actual postoperative fasting time, and the time to FFL and FFE. *P

Figure 2

The comparisons between gastrointestinal and…

Figure 2

The comparisons between gastrointestinal and non-gastrointestinal surgery. *P

Figure 2
The comparisons between gastrointestinal and non-gastrointestinal surgery. *P

Figure 3

The comparisons between general and…

Figure 3

The comparisons between general and regional anaesthesia. **P

Figure 3
The comparisons between general and regional anaesthesia. **P
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References
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Figure 2
Figure 2
The comparisons between gastrointestinal and non-gastrointestinal surgery. *P

Figure 3

The comparisons between general and…

Figure 3

The comparisons between general and regional anaesthesia. **P

Figure 3
The comparisons between general and regional anaesthesia. **P
Similar articles
References
    1. Osland E, Yunus RM, Khan S, et al. . Early versus traditional postoperative feeding in patients undergoing resectional gastrointestinal surgery. JPEN J Parenter Enteral Nutr 2011;35:473–87. 10.1177/0148607110385698 - DOI - PubMed
    1. Zhuang C-L, Ye X-Z, Zhang C-J, et al. . Early versus traditional postoperative oral feeding in patients undergoing elective colorectal surgery: a meta-analysis of randomized clinical trials. Dig Surg 2013;30:225–32. 10.1159/000353136 - DOI - PubMed
    1. Willcutts KF, Chung MC, Erenberg CL, et al. . Early oral feeding as compared with traditional timing of oral feeding after upper gastrointestinal surgery: a systematic review and meta-analysis. Ann Surg 2016;264:54–63. 10.1097/SLA.0000000000001644 - DOI - PubMed
    1. Pu H, Heighes PT, Simpson F, et al. . Early oral protein-containing diets following elective lower gastrointestinal tract surgery in adults: a meta-analysis of randomized clinical trials. Perioper Med 2021;10:10. 10.1186/s13741-021-00179-3 - DOI - PMC - PubMed
    1. Fanning J, Hojat R. Safety and efficacy of immediate postoperative feeding and bowel stimulation to prevent ileus after major gynecologic surgical procedures. J Osteopath Med 2011;111:469–72. 10.7556/jaoa.2011.111.8.469 - DOI - PubMed
Show all 32 references
Publication types
LinkOut - more resources
Full text links [x]
[x]
Cite
Copy Download .nbib
Format: AMA APA MLA NLM
Figure 3
Figure 3
The comparisons between general and regional anaesthesia. **P

References

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