Adjustment of Preoperative Fasting Guidelines for Adult Patients Undergoing Elective Surgery

Introduction: The typical order of nothing per oral (NPO) after midnight has been challenged in recent years, thus the American Society of Anesthesiology (ASA) revised in practice guidelines for preoperative fasting in healthy patients undergoing elective procedures, but many studies have showed that guidelines were not considered in clinical practice. The aim of this study was to evaluate the adjustment of preoperative NPO time with fasting guidelines in adult elective ophthalmic surgeries in a university educational ophthalmology hospital in Tabriz, Iran. Methods: In 3 months period, this descriptive study was conducted on 250 patients who scheduled for elective eye surgery. The investigator interviewed with patients before beginning of anesthesia and evaluated fasting duration for heavy meal, light meal and clear liquids and his or her satisfaction from NPO time and also investigated which staff recommended NPO time before anesthesia induction. Results: Fasting duration from heavy and light meal and clear liquids was 14.31 hours (8 - 23 hours), 12.46 hours (6 - 21 hours) and 11.54 hours (3 - 18 hours), respectively, that was not consistent with ASA guidelines. The discontent of the patients from prolonged NPO time was 60.8%. The most complaint was thirsty (42%). Ward nurses were the personnel who had the primary role in patients fasting time period (47.6%). Conclusion: Preoperative fasting duration for heavy and light meal and clear liquids for elective ophthalmic surgery in this teaching hospital was very long and not consistent with ASA guidelines. Ward nurses had the major role in this malpractice. Thus it seems that personnel education may be very helpful.