Evidence Based Approach to Preoperative Fasting Time Before Cesarean Section

Year 2018, Volume: 5 Issue: 1, 81 - 86, 11.02.2018

Tuba Kızılkaya , Asiye Gül

https://doi.org/10.17681/hsp.332781

Abstract

Evidence-based
practices includes the best interventions for the patients. There are some
evidences and suggestions about preoperative fasting time before cesarean
section. Restricting oral intake of liquids or solids from midnight is an old
practice called nil per os (NPO) is widely practiced in clinics. This is used
to minimize the complications of anesthesia such as aspiration and
regurgitation. When the surgical procedure delayed, fasting period is
prolonged. Prolonged fasting times can cause harm effects like dehydration,
insulin resistance, anxiety and headache. Current preoperative fasting
guidelines and evidence-based practices should be followed to reduce these
undesirable effects. Fasting from the intake of clear liquids for two hours;
solids for six or eight hours before surgery is suggested in the current
guidelines. Health professionals especially midwives who give care for women
before cesarean section, should follow the current guidelines to increase the quality
of healthcare. In this review, the effects of the pre-cesarean fasting period,
current practices and recommendations were discussed in order to increase the
knowledge level of health professionals.

Keywords

fasting, preoperative care, evidence-based practice, cesarean section

Sezaryen Öncesi Açlık Süresinde Kanıta Dayalı Yaklaşım / Evidence Based Approach to Preoperative Fasting Time Before Cesarean Section

Abstract

Kanıta
dayalı uygulamalar klinikte hastalar için en doğru kararı vermede etkili olan
uygulamaları içermektedir. Sezaryen öncesi hazırlık sürecinde açlık süresine
ilişkin kılavuzlarda çeşitli öneriler ve kanıt düzeyleri mevcuttur. Bu süreçte eski
bir uygulama olan nil per os (NPO) yani oral alımın gece yarısından itibaren kısıtlanması
yaygın olarak uygulanır. Bu kısıtlamanın amacı aspirasyon ve regurjitasyon gibi
anesteziye bağlı komplikasyonları en aza indirmektir. Cerrahi işlemin gecikmesi
veya ertelenmesi açlık süresinin daha fazla uzamasına neden olur. Açlık
süresinin uzaması ise dehidratasyon, insulin direnci, kaygı ve baş ağrısı gibi
olumsuz sonuçlara yol açabilir. Bu olumsuz sonuçları en az düzeye indirmek için
cerrahi öncesi açlıkla ilgili güncel kılavuzlar takip edilmelidir. Güncel
kılavuzlarda sezaryen öncesi son iki saate kadar sıvı gıda alımına, son 6-8
saate kadar da katı gıda alımına izin verilmektedir. Ebeler başta olmak üzere
sezaryen öncesi süreçte gebelere bakım veren sağlık profesyonelleri verilen
bakımın kalitesini artırmak için güncel kılavuzları takip etmeli ve önerilere
uygun girişimleri benimsemelidir. Bu derlemede sağlık profesyonellerinin konu
ile ilgili bilgi düzeylerini arttırmak amacıyla sezaryen öncesi açlık süresinin
etkileri, günümüzdeki uygulamalar ve öneriler ele alındı.

Keywords

açlık, ameliyat öncesi bakım, kanıta dayalı uygulama, sezaryen

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