Preoperative fasting is a safety procedure that aims to reduce the possibility of regurgitation and bronchoaspiration with the patient unconscious, with consequent aspiration pneumonitis or aspiration pneumonia, increased risk of death for the patient, increased length of hospital stay and costs. In this article, we will discuss the clinical conditions, diseases and medications that interfere with gastric emptying time, what bronchoaspiration is , the consequences of bronchoaspiration and the importance of preoperative fasting as a patient safety strategy.
Clinical conditions, diseases and medications that interfere with gastric emptying time
Gastric emptying is a complex process that can be influenced by various clinical conditions, diseases and medications. Some of the clinical conditions that can interfere with gastric emptying time include diabetes, hypothyroidism, abdominal surgery, rheumatological diseases, such as scleroderma, and stressful situations. Furthermore, some medications, such as GLP-1 analogues, vonoprazane fumarate , omeprazole, dexlansoprazole , rabeprazole sodium, cimetidine , domperidone and sodium bicarbonate, can also delay gastric emptying.
Bronchoaspiration : what it is and what the consequences are
Bronchoaspiration is the entry of foreign substances into the lower airways, triggering complications such as lung disease and severe malnutrition, which can even lead to death. Bronchoaspiration can occur during sleep, in cases of gastroesophageal reflux, in patients with difficulty swallowing, in patients with neurological diseases, in patients with neuromuscular diseases, in patients with pulmonary diseases and in patients undergoing anesthetic procedures. The consequences of bronchoaspiration include chronic cough, pneumonia, fever and sudden death in adults.
The importance of preoperative fasting as a patient safety strategy
Preoperative fasting is a safety strategy that aims to reduce the possibility of regurgitation and bronchoaspiration with the patient unconscious, with consequent aspiration pneumonitis or aspiration pneumonia, increased risk of death for the patient, increased length of hospital stay and costs. Preoperative fasting must be carried out for a minimum period of 6 hours for solid foods and 2 hours for clear liquids. It is important to emphasize that preoperative fasting should not be prolonged unnecessarily, as this can lead to dehydration, hypoglycemia and other health problems.
Preoperative assessment
A good preoperative assessment is essential to minimize the risks of regurgitation and bronchoaspiration during anesthesia. This assessment should include the patient’s clinical history, physical examination, airway assessment, pulmonary function assessment, cardiac function assessment, and renal function assessment. Furthermore, it is important that the patient is informed about preoperative fasting and the reasons why it is necessary.
Conclusion
Preoperative fasting is a safety strategy that aims to reduce the possibility of regurgitation and bronchoaspiration with the patient unconscious, with consequent aspiration pneumonitis or aspiration pneumonia, increased risk of death for the patient, increased length of hospital stay and costs. It is important that healthcare professionals are aware of the clinical conditions, illnesses and medications being used by the patient.
