Sun XH, Zhang YH, Zhang YT. Effect of shortening preoperative time of fasting and forbidding water on clinical outcome of elderly patients with gastrointestinal cancer.
Shijie Huaren Xiaohua Zazhi 2020;
28:58-64. [DOI:
10.11569/wcjd.v28.i2.58]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND
Prolonged fasting and water deprivation before surgery can easily lead to adverse reactions such as hunger, thirst, hypoglycemia, etc., especially in elderly patients. At present, most studies support shortening the duration of preoperative fasting and water, while domestic guidelines for preoperative fasting and water deprivation are for children, and there is no authoritative guide for adults.
AIM
To observe the effect of shortening preoperative time of fasting and forbidding water on the clinical outcome of elderly patients with gastrointestinal cancer.
METHODS
One hundred elderly patients with gastrointestinal cancer were divided into two groups (n = 50 each): experimental group and control group. The experimental group was fasted for 12 h and forbidden to drink water for 6 h before operation, and the control group was fasted for 6 h and forbidden to drink water for 2 h before operation. The changes of preoperative response, anesthesia effect, recovery time, hemodynamic index [mean arterial pressure (MAP), heart rate (HR)], and pulse oxygen saturation (SPO2) before and 5 min after surgery were recorded. Postoperative rehabilitation effect was also recorded.
RESULTS
There were 6 (12%) cases in the experimental group and 29 (58%) in the control group. Preoperative reactions such as thirst, starvation, fatigue, and hope for eating occurred; the incidence between the two groups was statistically significant (χ2 = 23.253, P < 0.001). The MAP, HR, and SPO2 were significantly decreased in the experimental group and the control group at 5 min after operation (P < 0.05). The HR and SPO2 at 5 min after operation in the experimental group were significantly higher than those in the control group (P > 0.05), although there was no significant difference in the MAP between the two groups (P < 0.05). There was no significant difference in the anesthesia effect between the two groups (P > 0.05), but there was a significant difference in the recovery time between them (t = -3.121, P = 0.002). There were significant differences in time to postoperative gastric tube removal, time to anal exhaust, time to body temperature recovery, and hospitalization days between the two groups (P < 0.05). There were no significant differences in postoperative nausea, postoperative vomiting, postoperative thirst, hunger, or postoperative pneumonia between the two groups (P > 0.05).
CONCLUSION
Reasonable arrangement of preoperative fasting time in elderly patients with gastrointestinal cancer may reduce the preoperative discomfort of patients and effectively improve the therapeutic effects, which is of great significance for the smooth performance of surgery and the promotion of postoperative rehabilitation.
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