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.	黃陳, 楊麗, 趙蓉, 等. 加速康復外科在促進日間手術多維度發展中的應用. 中國醫院管理, 2020, 40(2): 47-49.
2.	曹慶, 王穎, 朱毅. 關于加速康復外科理念在日間手術應用的探討. 中國康復醫學雜志, 2020, 35(7): 876-880.
3.	譚鴻霞, 文娟, 宋悅齡. 基于加速康復外科理念的圍手術期護理在不孕癥腹腔鏡日間手術患者中的應用效果. 中國醫藥科學, 2022, 12(14): 11-14.
4.	中華醫學會外科學分會, 中華醫學會麻醉學分會. 中國加速康復外科臨床實踐指南(2021 版). 中國實用外科雜志, 2021, 41(9): 961-992.
5.	中華醫學會婦產科學分會加速康復外科協作組. 婦科手術加速康復的中國專家共識. 中華婦產科雜志, 2019, 54(2): 73-79.
6.	文政偉, 張冠榮, 吳粵, 等. 加速康復外科診療模式實踐的效果及影響因素. 實用醫學雜志, 2021, 37(11): 1499-1503.
7.	張穎, 張燕, 王晶晶. 擇期手術前禁食禁飲時間的 Meta 分析. 臨床外科雜志, 2020, 28(2): 152-155.
8.	劉美玲, 殷彩欣, 肖玉梅, 等. 加速康復婦科日間手術患者安全性與舒適性評價. 護理與康復, 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.	葉衍涓, 姚瑤, 唐艷平, 等. 縮短全麻擇期手術患者術前禁食禁飲時間的品管圈實踐. 護理學報, 2021, 28(4): 9-11.
11.	左紅霞, 張超, 黃健健, 等. 不同術前禁食禁飲時間對我國擇期全身麻醉患者圍手術期影響的系統評價. 華西醫學, 2018, 33(8): 1005-1014.
12.	劉艷, 陳雪琴, 張黎. 骨科患者圍術期階梯性進食飲的臨床研究. 中國當代醫藥, 2020, 27(1): 190-193.
13.	劉燕. 子宮肌瘤剔除術合并胃腸動力障礙患者的最佳禁飲時間分析. 當代護士(中旬刊), 2022, 29(1): 97-101.
14.	齊一莎, 陳瑛琪, 魏昌偉, 等. 超聲法評估老年婦科惡性腫瘤患者術前碳水化合物負荷方案. 中國醫刊, 2021, 56(4): 443-446.
15.	金姬延. 加速康復外科理念下術前禁食管理的發展現狀. 中國微創外科雜志, 2019, 19(4): 360-362.
16.	劉常清, 任宏飛, 李繼平, 等. 日間手術管理模式與發展現狀. 護理研究, 2016, 30(28): 3466-3469.
17.	謝浩芬, 姜建帥. 日間手術醫療護理模式及發展現狀. 中華現代護理雜志, 2018, 24(12): 1365-1368.
18.	賴小琴, 王穎, 馬洪升, 等. 品管圈在降低日間手術當日停臺率中的應用研究. 華西醫學, 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.	張磊. 考慮多目標優化的日間手術排程研究. 北京: 北京交通大學, 2021.
21.	程博宇. 多資源的日間手術排程研究. 上海: 上海交通大學, 2019.
22.	周晴晴. 婦科腹部術后胃腸功能恢復影響因素的臨床研究. 廣州: 廣州中醫藥大學, 2012.
23.	馬吉蓮, 余萍, 梅玲. 加速康復外科指導下飲食營養干預在高原地區腹腔鏡膽囊摘除術患者圍手術期的應用. 天津護理, 2022, 30(1): 78-80.

1. 黃陳, 楊麗, 趙蓉, 等. 加速康復外科在促進日間手術多維度發展中的應用. 中國醫院管理, 2020, 40(2): 47-49.
2. 曹慶, 王穎, 朱毅. 關于加速康復外科理念在日間手術應用的探討. 中國康復醫學雜志, 2020, 35(7): 876-880.
3. 譚鴻霞, 文娟, 宋悅齡. 基于加速康復外科理念的圍手術期護理在不孕癥腹腔鏡日間手術患者中的應用效果. 中國醫藥科學, 2022, 12(14): 11-14.
4. 中華醫學會外科學分會, 中華醫學會麻醉學分會. 中國加速康復外科臨床實踐指南(2021 版). 中國實用外科雜志, 2021, 41(9): 961-992.
5. 中華醫學會婦產科學分會加速康復外科協作組. 婦科手術加速康復的中國專家共識. 中華婦產科雜志, 2019, 54(2): 73-79.
6. 文政偉, 張冠榮, 吳粵, 等. 加速康復外科診療模式實踐的效果及影響因素. 實用醫學雜志, 2021, 37(11): 1499-1503.
7. 張穎, 張燕, 王晶晶. 擇期手術前禁食禁飲時間的 Meta 分析. 臨床外科雜志, 2020, 28(2): 152-155.
8. 劉美玲, 殷彩欣, 肖玉梅, 等. 加速康復婦科日間手術患者安全性與舒適性評價. 護理與康復, 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. 葉衍涓, 姚瑤, 唐艷平, 等. 縮短全麻擇期手術患者術前禁食禁飲時間的品管圈實踐. 護理學報, 2021, 28(4): 9-11.
11. 左紅霞, 張超, 黃健健, 等. 不同術前禁食禁飲時間對我國擇期全身麻醉患者圍手術期影響的系統評價. 華西醫學, 2018, 33(8): 1005-1014.
12. 劉艷, 陳雪琴, 張黎. 骨科患者圍術期階梯性進食飲的臨床研究. 中國當代醫藥, 2020, 27(1): 190-193.
13. 劉燕. 子宮肌瘤剔除術合并胃腸動力障礙患者的最佳禁飲時間分析. 當代護士(中旬刊), 2022, 29(1): 97-101.
14. 齊一莎, 陳瑛琪, 魏昌偉, 等. 超聲法評估老年婦科惡性腫瘤患者術前碳水化合物負荷方案. 中國醫刊, 2021, 56(4): 443-446.
15. 金姬延. 加速康復外科理念下術前禁食管理的發展現狀. 中國微創外科雜志, 2019, 19(4): 360-362.
16. 劉常清, 任宏飛, 李繼平, 等. 日間手術管理模式與發展現狀. 護理研究, 2016, 30(28): 3466-3469.
17. 謝浩芬, 姜建帥. 日間手術醫療護理模式及發展現狀. 中華現代護理雜志, 2018, 24(12): 1365-1368.
18. 賴小琴, 王穎, 馬洪升, 等. 品管圈在降低日間手術當日停臺率中的應用研究. 華西醫學, 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. 張磊. 考慮多目標優化的日間手術排程研究. 北京: 北京交通大學, 2021.
21. 程博宇. 多資源的日間手術排程研究. 上海: 上海交通大學, 2019.
22. 周晴晴. 婦科腹部術后胃腸功能恢復影響因素的臨床研究. 廣州: 廣州中醫藥大學, 2012.
23. 馬吉蓮, 余萍, 梅玲. 加速康復外科指導下飲食營養干預在高原地區腹腔鏡膽囊摘除術患者圍手術期的應用. 天津護理, 2022, 30(1): 78-80.

West China Medical Journal

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

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