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Starving yourself hours before an op doesn't help‚ say UFS medics

By Dave Chambers | 2017-10-01 16:57:36.0

It’s a standard instruction if you’re having surgery in the morning: no food and drink after supper the night before.

 But it’s wrong.

A team of medical students at the University of the Free State found that every patient having elective surgery at the Universitas Hospital Annex in Bloemfontein fasts for too long.

And it’s not just an academic point. “It is associated with problems‚ including increased pre-operative nausea and vomiting‚” they write in the October edition of the South African Medical Journal.

 “Tissue repair is impaired by dehydration‚ and wound healing is improved when correct fluid fasting times are implemented.”

International guidelines say patients should abstain from food for six hours and from liquids for two hours before elective surgery.

But the UFS students‚ who investigated 105 patients‚ found that on average they abstained from foods and liquids for 10 hours. This was partly because of outdated advice from their doctors‚ and partly because they started fasting even earlier than doctors prescribed.

The students‚ supervised by Gillian Lamacraft‚ said the problem was exacerbated by fixed mealtimes at Universitas Hospital. “As a result of this study‚ the hospital will in future supply sandwiches for preoperative patients at 10pm the night before surgery and a carbohydrate-rich clear fluid drink at 5am on the day of surgery‚” they write.

“Such an approach has been proven to have no adverse effect on gastric volume or pH preoperatively compared with water or fasting from midnight. It has the positive effect of decreasing insulin resistance and increasing recovery of patients postoperatively.”