Impact of optimized preoperative fasting scheme for patients with gynecological day surgery under general anesthesia_West China Medical Journal

Authors：

LI Mingxuan ^1,2 , HE Jing ^1,2 , WANG Xiaofeng ^1,2 , CHEN Hengxi ^2,3 , TAN Xin ^2,3 ,  HU Juan ^2,4

1. Department of Day Surgery, West China Second University Hospital, Sichuan University / West China School of Nursing, Sichuan University, Chengdu, Sichuan 610066, P. R. China;
2. Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, Sichuan 610041, P. R. China;
3. Department of Day Surgery, West China Second University Hospital, Sichuan University, Chengdu, Sichuan 610066, P. R. China;
4. Department of Nursing, West China Second University Hospital, Sichuan University / West China School of Nursing, Sichuan University, Chengdu, Sichuan 610041, P. R. China;

Corresponding author：

HU Juan, Email: hujuan5@163.com

Keywords：

Day surgery; gynecology; surgery with general anesthesia; duration of water deprivation; anal exhaust

DOI：

10.7507/1002-0179.202211158

Video：

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Objective To investigate the impact of optimized preoperative fasting scheme for gynecological day surgery with general anesthesia. Methods We retrospectively selected 639 patients undergoing gynecological day surgery with general anesthesia between June 2021 and August 2021 in the day surgery department of West China Second University Hospital of Sichuan University as the control group, and 920 patients undergoing gynecological day surgery with general anesthesia in the same hospital between November 2021 and February 2022 as the observational group. The patients in the control group were treated with routine preoperative fasting scheme, and the ones in the observational group were treated with optimized preoperative fasting scheme. The differences in preoperative duration of water deprivation, intraoperative and postoperative incidences of aspiration, and postoperative first anal exhaust time between the two groups were compared. Results The preoperative duration of water deprivation in the control group was longer than that in the observational group [(12.49±2.63) vs. (6.69±2.76) h, P<0.05]. The incidences of intraoperative and postoperative aspiration were both 0. The postoperative first anal exhaust time in the control group was later than that in the observational group [(11.51±6.58) vs. (8.19±4.13) h, P<0.05]. Conclusions For patients undergoing gynecological day surgery with general anesthesia, the implementation of the optimized preoperative fasting scheme can effectively shorten the preoperative duration of water deprivation, without increasing the risk of anesthesia. It can accelerate the recovery of intestinal function for gynecological laparoscopic day surgery with general anesthesia, promote the implementation of enhanced recovery after surgery, and improve the efficiency of day surgery.

Citation： LI Mingxuan, HE Jing, WANG Xiaofeng, CHEN Hengxi, TAN Xin, HU Juan. Impact of optimized preoperative fasting scheme for patients with gynecological day surgery under general anesthesia. West China Medical Journal, 2023, 38(2): 206-209. doi: 10.7507/1002-0179.202211158 Copy

1.	黄陈, 杨丽, 赵蓉, 等. 加速康复外科在促进日间手术多维度发展中的应用. 中国医院管理, 2020, 40(2): 47-49.
2.	曹庆, 王颖, 朱毅. 关于加速康复外科理念在日间手术应用的探讨. 中国康复医学杂志, 2020, 35(7): 876-880.
3.	谭鸿霞, 文娟, 宋悦龄. 基于加速康复外科理念的围手术期护理在不孕症腹腔镜日间手术患者中的应用效果. 中国医药科学, 2022, 12(14): 11-14.
4.	中华医学会外科学分会, 中华医学会麻醉学分会. 中国加速康复外科临床实践指南(2021 版). 中国实用外科杂志, 2021, 41(9): 961-992.
5.	中华医学会妇产科学分会加速康复外科协作组. 妇科手术加速康复的中国专家共识. 中华妇产科杂志, 2019, 54(2): 73-79.
6.	文政伟, 张冠荣, 吴粤, 等. 加速康复外科诊疗模式实践的效果及影响因素. 实用医学杂志, 2021, 37(11): 1499-1503.
7.	张颖, 张燕, 王晶晶. 择期手术前禁食禁饮时间的 Meta 分析. 临床外科杂志, 2020, 28(2): 152-155.
8.	刘美玲, 殷彩欣, 肖玉梅, 等. 加速康复妇科日间手术患者安全性与舒适性评价. 护理与康复, 2019, 18(9): 43-46.
9.	Nicholson A, Lowe MC, Parker J, et al. Systematic review and meta-analysis of enhanced recovery programmes in surgical patients. Br J Surg, 2014, 101(3): 172-188.
10.	叶衍涓, 姚瑶, 唐艳平, 等. 缩短全麻择期手术患者术前禁食禁饮时间的品管圈实践. 护理学报, 2021, 28(4): 9-11.
11.	左红霞, 张超, 黄健健, 等. 不同术前禁食禁饮时间对我国择期全身麻醉患者围手术期影响的系统评价. 华西医学, 2018, 33(8): 1005-1014.
12.	刘艳, 陈雪琴, 张黎. 骨科患者围术期阶梯性进食饮的临床研究. 中国当代医药, 2020, 27(1): 190-193.
13.	刘燕. 子宫肌瘤剔除术合并胃肠动力障碍患者的最佳禁饮时间分析. 当代护士(中旬刊), 2022, 29(1): 97-101.
14.	齐一莎, 陈瑛琪, 魏昌伟, 等. 超声法评估老年妇科恶性肿瘤患者术前碳水化合物负荷方案. 中国医刊, 2021, 56(4): 443-446.
15.	金姬延. 加速康复外科理念下术前禁食管理的发展现状. 中国微创外科杂志, 2019, 19(4): 360-362.
16.	刘常清, 任宏飞, 李继平, 等. 日间手术管理模式与发展现状. 护理研究, 2016, 30(28): 3466-3469.
17.	谢浩芬, 姜建帅. 日间手术医疗护理模式及发展现状. 中华现代护理杂志, 2018, 24(12): 1365-1368.
18.	赖小琴, 王颖, 马洪升, 等. 品管圈在降低日间手术当日停台率中的应用研究. 华西医学, 2020, 35(2): 181-186.
19.	Dagher C, Tohme J, Bou Chebl R, et al. Preoperative fasting: assessment of the practices of Lebanese anesthesiologists. Saudi J Anaesth, 2019, 13(3): 184-190.
20.	张磊. 考虑多目标优化的日间手术排程研究. 北京: 北京交通大学, 2021.
21.	程博宇. 多资源的日间手术排程研究. 上海: 上海交通大学, 2019.
22.	周晴晴. 妇科腹部术后胃肠功能恢复影响因素的临床研究. 广州: 广州中医药大学, 2012.
23.	马吉莲, 余萍, 梅玲. 加速康复外科指导下饮食营养干预在高原地区腹腔镜胆囊摘除术患者围手术期的应用. 天津护理, 2022, 30(1): 78-80.

1. 黄陈, 杨丽, 赵蓉, 等. 加速康复外科在促进日间手术多维度发展中的应用. 中国医院管理, 2020, 40(2): 47-49.
2. 曹庆, 王颖, 朱毅. 关于加速康复外科理念在日间手术应用的探讨. 中国康复医学杂志, 2020, 35(7): 876-880.
3. 谭鸿霞, 文娟, 宋悦龄. 基于加速康复外科理念的围手术期护理在不孕症腹腔镜日间手术患者中的应用效果. 中国医药科学, 2022, 12(14): 11-14.
4. 中华医学会外科学分会, 中华医学会麻醉学分会. 中国加速康复外科临床实践指南(2021 版). 中国实用外科杂志, 2021, 41(9): 961-992.
5. 中华医学会妇产科学分会加速康复外科协作组. 妇科手术加速康复的中国专家共识. 中华妇产科杂志, 2019, 54(2): 73-79.
6. 文政伟, 张冠荣, 吴粤, 等. 加速康复外科诊疗模式实践的效果及影响因素. 实用医学杂志, 2021, 37(11): 1499-1503.
7. 张颖, 张燕, 王晶晶. 择期手术前禁食禁饮时间的 Meta 分析. 临床外科杂志, 2020, 28(2): 152-155.
8. 刘美玲, 殷彩欣, 肖玉梅, 等. 加速康复妇科日间手术患者安全性与舒适性评价. 护理与康复, 2019, 18(9): 43-46.
9. Nicholson A, Lowe MC, Parker J, et al. Systematic review and meta-analysis of enhanced recovery programmes in surgical patients. Br J Surg, 2014, 101(3): 172-188.
10. 叶衍涓, 姚瑶, 唐艳平, 等. 缩短全麻择期手术患者术前禁食禁饮时间的品管圈实践. 护理学报, 2021, 28(4): 9-11.
11. 左红霞, 张超, 黄健健, 等. 不同术前禁食禁饮时间对我国择期全身麻醉患者围手术期影响的系统评价. 华西医学, 2018, 33(8): 1005-1014.
12. 刘艳, 陈雪琴, 张黎. 骨科患者围术期阶梯性进食饮的临床研究. 中国当代医药, 2020, 27(1): 190-193.
13. 刘燕. 子宫肌瘤剔除术合并胃肠动力障碍患者的最佳禁饮时间分析. 当代护士(中旬刊), 2022, 29(1): 97-101.
14. 齐一莎, 陈瑛琪, 魏昌伟, 等. 超声法评估老年妇科恶性肿瘤患者术前碳水化合物负荷方案. 中国医刊, 2021, 56(4): 443-446.
15. 金姬延. 加速康复外科理念下术前禁食管理的发展现状. 中国微创外科杂志, 2019, 19(4): 360-362.
16. 刘常清, 任宏飞, 李继平, 等. 日间手术管理模式与发展现状. 护理研究, 2016, 30(28): 3466-3469.
17. 谢浩芬, 姜建帅. 日间手术医疗护理模式及发展现状. 中华现代护理杂志, 2018, 24(12): 1365-1368.
18. 赖小琴, 王颖, 马洪升, 等. 品管圈在降低日间手术当日停台率中的应用研究. 华西医学, 2020, 35(2): 181-186.
19. Dagher C, Tohme J, Bou Chebl R, et al. Preoperative fasting: assessment of the practices of Lebanese anesthesiologists. Saudi J Anaesth, 2019, 13(3): 184-190.
20. 张磊. 考虑多目标优化的日间手术排程研究. 北京: 北京交通大学, 2021.
21. 程博宇. 多资源的日间手术排程研究. 上海: 上海交通大学, 2019.
22. 周晴晴. 妇科腹部术后胃肠功能恢复影响因素的临床研究. 广州: 广州中医药大学, 2012.
23. 马吉莲, 余萍, 梅玲. 加速康复外科指导下饮食营养干预在高原地区腹腔镜胆囊摘除术患者围手术期的应用. 天津护理, 2022, 30(1): 78-80.

West China Medical Journal

Impact of optimized preoperative fasting scheme for patients with gynecological day surgery under general anesthesia

Abstract Full text Figures/Tables Video References Cited by

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