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Aspiration related to anesthesia was not identified among the randomized and prospective studies conducted among participants that ate high carbohydrate drink. In their study characterized by a sample of patients undergoing anesthesia and provided with a solution of ml of Fasting prior to anesthesia is important in avoiding the risk of pulmonary aspiration.

The suggestions to fast before an operation is associated with the assumption that food which is consumed just before an operation remains in the gastric system, thus increasing the risk related to aspiration. Additionally, there is also an assumption that abstaining from food before a surgery is likely to reduce the chances of aspiration. This is through the reduction of preoperative discomfort such as thirst, fatigue and hunger as well as early postoperative complications related to pain and vomiting.

The study further identified that the level of these discomforts were found to be significantly higher in the fasting and glucose groups as compared to CHD groups. Thus, CHH treatment can be applied in enhancing comfort for patients that are about to undergo thyroidectomy. The study showed good results from the new behaviors and suggested that they should be encouraged to reduce the recovery time of the patients undergoing surgery.

In more detailed analysis of the manner in which CHO supplementation plays a protective role in surgical processes, Gjessing, et al argue that CHO supplementation in the preoperative phase reduces the trauma resulting from surgery.

The intake of CHO acts to enhance the protective role of preoperative CHO supplementation on the development of insulin resistance after surgery.

Although various studies have discovered that the carbohydrate-rich fluids are beneficial in improving the postoperative recovery, the effectiveness of the fluids in reducing the length of hospital is uncertain.

In a study that focused on the assessment of the effectiveness of preoperative loading with the carbohydrates on postoperative outcomes, Webster, et al, found a positive association between the use of preoperative high carbohydrate fluids and recovery.

However, the study was unable to confirm or refute the benefits CHO for a shorter period of hospital stay following a surgery. However, not all studies have found the administration of carbohydrates effective in the improving the conditions of an operation procedure. Aspiration was also absent in both scenarios. However, fasting has been identified to be ineffective in preventing the complications associated with medical surgery.

For instance, an observational study by Hamid, et al. Pre-procedural fasting has also been found ineffective in improving comfort and satisfaction. The results of the study confirm the necessity of following safer and flexible fasting policies before an operation, including the ones guiding the intake of oral fluids. Also, the results of this study indicate that taking of clear fluids preoperatively in a parturient is safe, and in the cases requiring urgent cesarean, the risks of regurgitation and aspiration are not likely to increase.

Samantaray suggest that the pulmonary aspiration of the gastric contents causes aspiration pneumonia that is life threatening. Patients booked for elective surgery are always advised to refrain from eating or drinking after midnight of the previous day from when their surgery is scheduled. According to Maltby fasting before elective surgery prevents the incidences of regurgitation of the stomach contents. This is the reason why preoperative fasting was initially recommended for the reduction of the postoperative nausea and vomiting Maltby, Obese patients without comorbid conditions are also advised to follow similar fasting guidelines as the non-obese patients and be allowed access to clear drinks two hours prior to the elective surgery.

Fortunately, the current death cases related to pulmonary aspiration during surgery are low. Samantaray attribute the low occurrences of aspiration during anesthesia to the increased awareness on pulmonary aspiration and improvement in anesthetic techniques rather than the use of the traditional fasting guidelines. However, the implementation of the guidelines has been sometimes difficult making the aspect remain suboptimal.

Additionally, the implementation of the guidelines is subject to other studies that found out that that the fasting guidelines can have the contrary results tom the ones proposed by the various studies. As per the results of this study, pulmonary aspiration should not be a course worry much about during anesthesia. The decreased incidents of pulmonary aspiration, however, indicates that use of only study patients could be leading to inaccurate results.

These studies always find it difficult because these problems are rare among children. Studies have also identified the gender differences in the fasting practices for patients about to undergo anesthesia. In a study on High-risk residual gastric content in fasted patients undergoing gastrointestinal endoscopy: The difference was noted to be less pronounced with the increase in age. These results were obtained from an examination of the residual gastric contents of fasted patients that were under medication for gastrointestinal endoscopy, the study found out that the males presented for endoscopy.

However, this study could not confirm or exclude the involvement of the various factors related to old age. The differences in the fasting results across gender were also found to be existent among children. The study concluded that fasting for one hour does not alter the pH significantly as compared to fasting for two hours. Preoperative fasting practices normally prolong than the set practice procedures while the medical procedures are not always given to the patients before they are ushered into surgery.

The fasting guidelines for people having elective surgery published by ASA in relied on the analysis of more than studies, expert inputs and sophisticated statistical techniques. Some of the guidelines include ensuring a minimum fast two hours from clear liquids, eight hours from heavy foods, six hours from a light meal or infant formula and fours from breast milk. However, these guidelines had been already suggested earlier.

In a study that involved random assigning of low-risk patients undertaking the morning surgery in 6 university affiliated hospitals to an oral rehydration solution ORS group or the fasting one, it was found out that the Oral rehydration therapy up to 2hours prior to the surgery is safe among the low-risk Japanese surgical population Itou et al.

According to this study, physicians have an obligation of using the practice for maintaining the amount of body water and electrolytes and ensuring the comfort of the patient. Fasting Guidelines and Recommendations. One of the most common forms of the failure to adhere to the set fasting guidelines occurs in the form of fasting beyond the set periods.

Fasting beyond the set requirements was also observed by Roberts in a clinical audit on preoperative fasting. According to them, most patients are needlessly fasting for a prolonged period of time from both food and water which might complicate their healing process. However, the article failed to give a clear reasoning on why since mo research was carried out. Prolonged pre-operative fasting is termed as an unpleasant experience that possesses the capacity to cause serious medical complications.

Inappropriate pre-operative fasting was also revealed by Hamid in his audit on Moorfields South PAU whereby the fasting instructions was not concordant with the national guidelines leading to serious negative impacts on patients.

Patients were found to be fast in an inappropriate manner and over prolonged period of time, leading to discomfort as well as the subjective and objective dehydration. The failure to implement these guidelines is also associated with ignorance on the side of anesthetists. They indicate that the national published guidelines are essential for the promotion of shorter durations which are more effective than the previous ones.

These guidelines have almost been rendered ineffective since various studies have not found link between their application and the pre- and post-operative safety: Indeed, several randomized trials have failed to show any link between non-fasted patients and pulmonary aspiration. Therefore, there is no reason to recommend fasting patients prior to procedural sedation in the ED..

This is because their health conditions are characterized by a range of health conditions that may complicate the application of the fasting guidelines. According to Wei, et al. In matters compliance, studies have found out that compliance does not necessarily mean that the patient understands the advantages of the guidelines. A total of patients were put under survey through being asked to answer an point questionnaire on the demographics, fasting before surgery and the attitudes related to fasting.

Although this may led to unintentional compliance, there is a need of the health care givers to inform patients on the necessity of the practice to ensure that they intentionally and knowledgeably comply.

In this regard, it is important for the nurses to understand the scientific aspects that guide fasting practices and what they are supposed to teach patients. Hamid argues that there is a need to educate the health professionals on the changes related to the guideline practices and the new findings from the various scientific studies on the topic. Utilization of the evidence- and patient-based approach to pre-operative fasting is essential in the improvement of patient satisfaction.

According to Hamid correct fasting intervals are essential for curtailing the inconveniences related to delay in surgery, reducing the medical complications and improving the post operative wellbeing. Safe intake of an oral supplement containing carbohydrates and whey protein shortly before sedation to gastroscopy: The Effect of Preoperative Oral.

Carbohydrate Solution Intake on Patient Comfort: A Randomized Controlled Study. Journal of Perianesthesia Nursing. Preoperative Fasting Duration and Medication. Curr Opin Crit Care , Preoperative carbohydrate supplementation attenuates post-surgery insulin resistance via reduced inflammatory inhibition of the insulin-mediated restraint on muscle pyruvate dehydrogenase kinase 4 expression.

The effects of oral fluid intake. Pre-operative fasting — a patient centered approach. Pre-procedural fasting for coronary interventions: Reduced fasting time improves. Safety and efficacy of oral rehydration therapy until 2 h before surgery: A multicenter randomized controlled trial.

An audit of preoperative fasting compliance at a major. Lesser time of preoperative. Arquivos Brasileiros De Cirurgia Digestiva: We provide fresh and originally developed content on reviewing the research papers. Any information extracted or content written is either referenced properly or quoted to avoid plagiarism. Inferences are drawn from the reference papers preserving the essence of the paper. Based on the prescribed guidelines and format of your university, literature review is drafted by experts having doctoral degree in the relevant field of research.

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