The perioperative effects of preoperative fasting time on the healthy adults undergoing laparoscopic cholecystectomy

Abstract

Objective: The effect of varying the durations of fasting on perioperative complications was investigated in patients undergoing elective laparoscopic cholecystectomy. Material and Methods: This prospective observational clinical trial was performed on 76 patients who underwent elective laparoscopic cholecystectomy and fulfilled the necessary criteria between March 2012 and August 2012 The patients were divided into two groups: Induction of anesthesia performed in the morning (Group I) and induction of anesthesia performed in the afternoon (Group II). Liquid and solid food intake times were compared with the following parameters between the two groups: Perioperative tremor, fasting, thirst, fatigue, gastric residual volume, gastric pH and vital parameters. Results: The mean fluid restriction time was 10.3 ± 1.2 hours in Group 1 and 14.8 ± 1.4 hours in Group 2 (p<0.001). The mean solid food restriction time was 12.9 ± 2.2 and 16.6 ± 2.9 hours in Group I and Group II, respectively (p<0.001). Variations in percentage of mean arterial pressure values after two minutes following anesthesia induction were significantly lower in Group II compared to Group I (p=0.003). One patients developed hypotension after the induction in Group I (2.4 %) while this number was 6 in Group II (17.1%) (p=0.034). Gastric residual volume was found significantly higher in Group I [12 (0-40) ml] compared to Group II [24 (0-45) ml] (p=0.010). The number of patients at risk of pulmonary aspiration were 2 in Group I and 8 in Group II (p=0.037). Conclusion: The preoperative fasting period was much longer than intended in patients who underwent elective laparoscopic cholecystectomy especially in the afternoon. This study showed that prolongation of fasting and thirst period may cause increase in gastric residual volume, development of hypotension after induction of anesthesia, and the increased risk for pulmonary aspiration. © 2014 by Türkiye Klinikleri.