Abstract

Aspiration of gastric content during anesthesia and its life-threatening consequences in form of aspiration pneumonia and respiratory failure is a rare but still catastrophic complication of anesthesia. Keeping patients’ nil per oral (NPO) from midnight has been followed as a standard practice worldwide for a long time.Various anesthesia society has modified their fastingrecommendations time by time but still, traditional midnight NPO practice is followed in many non-institutional hospitals in India. The present study was conducted to assess that does clear liquid intake up to 2 hr. before surgery improves perioperative patient comfort and is it safe to practice in elective surgeries.
Methodology: A observational prospective study was conducted among patients who were posted for elective surgeries under general anesthesia. Patients who were having a higher risk of aspiration including obesity, pregnancy, emergency surgeries, diabetes, difficult airways, and were not willing to participate in the study were excluded from the study. The patients were divided into 2 groups (Group1- that followed the instruction of taking clear liquids up to 2 hrs prior to surgery and group 2- not followed the instruction and followed traditional fasting).
Data collection and analysis: Patients were assessed with a questionnaire, which included perception of thirst, hunger, anxiety, and weakness as a measure of subjective comfort. The proportion was calculated for categorical variables and mean and Standard deviation were calculated for continuous variables. T-test for continuous variables and Chi-square test for categorical variables were used to compare the data between the two groups. The level of significance was kept at 0.05 level.
Results: Perioperative comparison of both the groups showed no statistically significant difference in Mean FBS, Events of aspiration, post-op pain, PONV, pre-op hunger, and pre-op weakness between the two groups.Statistically, a significant difference was found in satisfaction level, pre-op thirst, and pre-op anxiety levels in both groups.
Conclusion: Liberal preoperative fasting in form of allowing clear liquid up to 2 hr. before surgery is safe to practice.