Preoperative fasting times for patients undergoing caesarean delivery: before and after a patient educational initiative [Turk J Anaesthesiol Reanim]
Turk J Anaesthesiol Reanim. Ahead of Print: TARD-95770

Preoperative fasting times for patients undergoing caesarean delivery: before and after a patient educational initiative

Brendan Carvalho1, Mary Yurashevich1, Adrian Chow2, John J Kowalczyk1, Andrea J Traynor1
1Department Of Anaesthesiology, Perioperative And Pain Medicine, Stanford University School Of Medicine, Stanford, Ca Usa
2Eastern Virginia Medical School, Norfolk, Va, Usa

Objective: Prolonged preoperative fasting may lead to dehydration, hypoglycaemia, ketoacidosis and delayed recovery. We hypothesized that a patient educational initiative would decrease our preoperative fasting periods for elective caesarean delivery.
Methods: An observational quality improvement impact study. Elective caesarean patients who delivered during our study period were included; 40 patients in pre-intervention and 40 patients in post-intervention groups. No exclusions except only English-speaking patients were included. We developed a patient educational pamphlet outlining preoperative fasting and analgesic expectations for caesarean delivery which was given 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 for liquids (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 hours [8.9-12] to 3.5 hours [2.5-10] (p < 0.001). The fasting period for solids was not significantly different: 12.5 hours [10.5-14] pre- vs. 12.4 hours [10.6-14] post-pamphlet introduction (p = 0.384). Despite the recommendation, only 22.5% consumed a carbohydrate-containing drink with a modest decrease in water consumption (87.5% before and 67.5% after; p = 0.009).
Conclusion: A patient educational pamphlet significantly reduced fasting time for clear liquids. Future studies are needed to determine what barriers limited adherence to the recommended carbohydrate-containing drink consumption.

Keywords: Cesarean delivery, Fasting, Education, Quality assurance, Enhanced recovery.

Corresponding Author: Brendan Carvalho, United States

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