A prospective cohort study on reducing perioperative fasting in traumatic patients following Enhanced Recovery After Surgery protocol

Objective To evaluate the effectiveness of perioperative fasting abbreviation in traumatic patients undergoing selective surgeries. Methods The traumatic patients undergoing selective surgeries from November 2016 to January 2017 at our department were selected for this prospective cohort study.They were divided into an intervention group (69 patients) and a control group (121 patients) according to the wards where they stayed.The intervention group was fasted for solids 6 hours prior to surgery and received oral solution with maltodextrin 2 hours prior to surgery. After surgery, they were allowed to drink liquids as soon as they were awakened. Normal food was allowed 2 hours later. The control group was fasted for either liquids or solids the night before surgery. After surgery, the patients who had received brachial plexus block only were allowed liquids with no limitation while the other patients were allowed liquids 6 hours after surgery and then were free for solids and liquids if no discomfort was observed. The time periods for preoperative liquids and solids fasting and for postoperative intake of liquids and solids were recorded and compared between the 2 groups. The perioperative well-beings (including anxiety, thirst, hunger, nausea, fatigue, dizziness, sweating and stomach discomfort) and serum glucose levels were compared between the 2 groups. Adverse reactions were observed. Results The preoperative fasting time for liquids for the intervention group (4.5±2.9 hours) was significantly shorter than that for the control group (14.3±3.9 hours) (P 0.05). No major adverse reaction was observed in either group. Conclusion The protocol of perioperative fasting abbreviation may be safe and feasible in traumatic patients for selective surgeries, showing benefits of decreased anxiety, thirst, hunger, nausea, fatigue, dizziness and stomach discomfort. Key words: Perioperative care; Wounds and injuries; Water deprivation; Fasting