Ürolojik cerrahi hastalarında açlık süresi ile ameliyat sonrası bulantı-kusma arasındaki ilişkinin incelenmesi

Abstract

Amaç: Bu çalışmada, ürolojik cerrahi hastalarında ameliyat sonrası açlık süresi ile bulantı kusma arasındaki ilişkinin incelenmesi amaçlandı. Yöntem: Tanımlayıcı desendeki bu çalışmanın örneklemini Mersin ilinin bir devlet hastanesinde ürolojik cerrahi geçiren 124 hasta oluşturdu. Araştırma verileri, Ocak-Mayıs 2025 tarihleri arasında araştırmacılar tarafından “Tanıtıcı Özellikler Formu”, “Hasta İzlem Formu” ve “Apfel Risk Skorlama Sistemi” ile yüz yüze toplandı. Bulgular: Hastaların yaş ortalaması 53.27 yıldır. Hastaların ameliyat öncesi katı açlık süresi 10 saat (ss= 2.55), ameliyat öncesi sıvı açlık süresi ise 9.34 saat (ss=2.45) olup, ameliyat sonrası katı açlık süresi 3.75 saat (ss=1.80), ameliyat sonrası sıvı açlık süresi ise 2.95 saattir (ss=1.35). Hastaların 24 saat içerisinde en az bir kere bulantı-kusma yaşama oranı %33.87 olarak saptandı. Ameliyat sonrası 0. ve 2. saatlerde bulantı-kusma yaşayan hastaların sırasıyla ameliyat öncesi ve ameliyat sonrası sıvı açlık sürelerinin anlamlı şekilde yüksek olduğu belirlendi (p<0.05). Ameliyat sonrası 0., 2. ve 6. saatlerde bulantı-kusma gelişen hastaların APFEL skorları da anlamlı olarak daha yüksekti (p<0.05). Sonuç: Araştırma bulguları, ameliyat sonrası 0. ve 2. saatlerde bulantı-kusma yaşayan hastaların sırasıyla ameliyat öncesi ve sonrası sıvı açlık sürelerinin daha uzun olduğunu gösterdi. Bu bulgu, ürolojik cerrahi hastalarında sıvı açlık sürelerinin ameliyat sonrası bulantı-kusma gelişiminde etkili bir faktör olabileceğine işaret etmektedir. Bu bağlamda, kanıt temelli rehber önerilerinin sahaya entegrasyonun sağlanması için kurumsal politikalarda düzenlemelerin yapılması ve sağlık profesyonellerinin bilinçlendirilmesi önerilmektedir.

Keywords

• Üriner
• cerrahi
• açlık süresi
• ameliyat sonrası bulantı kusma

Determination of the relationship between fasting time and postoperative nausea and vomiting in patients undergoing urological surgery

Abstract

Aim: This study aimed to examine the relationship between postoperative fasting duration and postoperative nausea and vomiting in patients undergoing urological surgery. Method: This descriptive study included a sample of 124 patients who underwent urinary system surgery at a state hospital in Mersin, Türkiye. Data were collected face-to-face by the researchers between January-May 2025 using the “Descriptive Characteristics Form,” “Patient Follow-up Form,” and the “Apfel Risk Scoring System.” Results: The mean age of the patients was 53.27 years. The mean preoperative solid fasting duration was 10 hours (sd = 2.55), and the mean preoperative liquid fasting duration was 9.34 hours (sd = 2.45). The mean postoperative solid fasting duration was 3.75 hours (sd = 1.80), and the mean postoperative liquid fasting duration was 2.95 hours (sd = 1.35). Within 24 hours after surgery, 33.87% of patients experienced at least one episode of nausea or vomiting. atients who experienced nausea-vomiting at postoperative hours 0 and 2 had significantly longer preoperative and postoperative liquid fasting durations, respectively (p <0.05). In addition, Apfel scores were significantly higher in patients who developed nausea-vomiting at postoperative 0, 2, and 6 hours (p <0.05). Conclusion: The findings showed that patients who experienced nausea-vomiting at postoperative 0 and 2 hours had longer preoperative and postoperative liquid fasting durations, respectively. This result suggests that liquid fasting duration may be an influential factor in the development of postoperative nausea and vomiting in patients undergoing urological surgery. In this context, it is recommended to implement institutional policy adjustments and raise awareness among healthcare professionals to ensure the integration of evidence-based guideline recommendations into clinical practice.

Keywords

• Urinary
• surgery
• fasting duration
• postoperative nausea and vomiting

References

1. Brooke L. Starving for Surgery: An Integrative Review. Carol Digit Repos. Published online 2020. doi:https://doi.org/10.17615/ptbz-r208
2. Gündoğu RH. Current approach to perioperative nutrition in the ERAS age. Clin Sci Nutr. 2019;1(1):1-10. doi:10.5152/ClinSciNutr.2019.79
3. ERAS Türkiye Derneği. Accessed June 16, 2025. https://eras.org.tr/page.php?id=10
4. Gillis C, Carli F. Promoting Perioperative Metabolic and Nutritional Care. Anesthesiology. 2015;123(6):1455. doi:10.1097/ALN.0000000000000795
5. Liang Y, Yan X, Liao Y. The effect of shortening the preoperative fasting period on patient comfort and gastrointestinal function after elective laparoscopic surgery. Am J Transl Res. 2021;13(11):13067-13075.
6. İster G, Erbaş DH, Aslan FE. The Effect of Prolonged Fasting Before Surgery on Pain and Anxiety. J Perianesth Nurs. 2025;40(2):377-380. doi:10.1016/j.jopan.2024.05.020
7. Gul A, Andsoy II, Ozkaya B. Preoperative Fasting and Patients’ Discomfort. Indian J Surg. 2018;80(6):549-553. doi:10.1007/s12262-017-1657-4
8. Demi̇rdağ H, Cengi̇z HÖ, Erdoğan B, Soytürk ES, Kurt B, Uygun AN. Ürolojik Cerrahi Girişim Uygulanan Hastalarda Ameliyat Öncesi Açlık Süresi İle Ameliyat Sonrası İyileşme Kalitesi Arasındaki İlişkinin Belirlenmesi: Tanımlayıcı Çalışma. Turk Klin J Nurs Sci. 2024;16(1):17-25. doi:10.5336/nurses.2023-100158

9. Şişman H, Arslan S, Gezer D, Akpolat R, Alptekin D, Gökçe E. The effect of Apfel risk score and fasting times on postoperative nausea and vomiting: Post-Operative Nausea and Vomiting. Perioper Care Oper Room Manag. 2022;29:100283. doi:10.1016/j.pcorm.2022.100283
10. Munsterman C, Strauss P. Early Rehydration in Surgical Patients With Prolonged Fasting Decreases Postoperative Nausea and Vomiting. J Perianesth Nurs. 2018;33(5):626-631. doi:10.1016/j.jopan.2017.06.124
11. Shaikh SI, Nagarekha D, Hegade G, Marutheesh M. Postoperative nausea and vomiting: A simple yet complex problem. Anesth Essays Res. 2016;10(3):388. doi:10.4103/0259-1162.179310
12. Karmana D, Sebayang SM, Firdaus EK, Sukmaningtyas W. The Correlation Between Pre-Operative Fasting Duration and Post-Operative Nausea and Vomiting Occurrence on Patients with General Anestehesia. Java Nurs J. 2024;2(1). doi:10.61716/jnj.v2i1.33
13. Muliono SHK, Susanto A, Sebayang S. The Relationship Between Fasting Duration and The Incidence of Post Operative Nausea and Vomiting in Spinal Anesthesia Patients. Java Nurs J. 2024;2(3):359-366. doi:10.61716/jnj.v2i3.83
14. Yilmaz N, Cekmen N, Bilgin F, Erten E, Ozhan MÖ, Coşar A. Preoperative carbohydrate nutrition reduces postoperative nausea and vomiting compared to preoperative fasting. J Res Med Sci Off J Isfahan Univ Med Sci. 2013;18(10):827-832.
15. Pierre S, Benais H, Pouymayou J. Apfel’s simplified score may favourably predict the risk of postoperative nausea and vomiting. Can J Anesth. 2002;49(3):237-242. doi:10.1007/BF03020521
16. Çetin N. Tek Seviye Servikal Cerrahi Uygulanan Hastalarda Nane Yağının Ameliyat Sonrası Bulantı Kusma Üzerine Etkisinin Belirlenmesi. Yüksek Lisans Tezi. Muğla Sıtkı Koçman Üniversitesi; 2023.
17. Chon T, Ma A, Mun-Price C, Chon T, Ma AC, Mun-Price C. Perioperative Fasting and the Patient Experience. Cureus. 2017;9(5). doi:10.7759/cureus.1272
18. Morrison CE, Ritchie-McLean S, Jha A, Mythen M. Two hours too long: time to review fasting guidelines for clear fluids. Br J Anaesth. 2020;124(4):363-366. doi:10.1016/j.bja.2019.11.036
19. Basirimoghadam K, Hosseini-Moghaddam F, Basirimoghadam M, Gholamzadehkafi A, Mahyachor H, Moradi M. The Relationship between Fasting Duration before Urological Surgeries and Postoperative Renal Function. J Isfahan Med Sch. 2020;38(595):758-763. doi:10.22122/jims.v38i595.13243
20. Bayramoğlu BG, Akyüz N. Investigation of Preoperative Fasting Time and Preoperative and Postoperative Well-Being of Patients. Florence Nightingale J Nurs. 2022;30(1):33-39. doi:10.5152/FNJN.2022.21047
21. Baye WL, Kitessa EG. Preoperative Fasting Time and Factorrs Affecting Adherence to Preoperative Fasting Time Among Adult Patient Undergoing Elective Surgery at Siant Paul’s Hospital Millennium Medical College, Adis Ababa Ethiopia. Perioper Care Oper Room Manag. 2025;38:100470. doi:10.1016/j.pcorm.2025.100470
22. Coutinho RB, Peres WAF, Paula TP de. Association between preoperative fasting time and clinical outcomes in surgical patients in a private general hospital. Acta Cirúrgica Bras. 2024;39:e394524. doi:https://doi.org/10.1590/acb394524
23. van Noort HHJ, Eskes AM, Vermeulen H, et al. Fasting habits over a 10-year period: An observational study on adherence to preoperative fasting and postoperative restoration of oral intake in 2 Dutch hospitals. Surgery. 2021;170(2):532-540. doi:10.1016/j.surg.2021.01.037
24. Sinha V, Vivekanand D, Singh S. Prevalence and risk factors of post-operative nausea and vomiting in a tertiary-care hospital: A cross-sectional observational study. Med J Armed Forces India. 2022;78:S158-S162. doi:10.1016/j.mjafi.2020.10.024
25. Maraş G, Bulut H. Prevalence of Nausea-Vomiting and Coping Strategies in Patients Undergoing Outpatient Surgery. J Perianesth Nurs. 2021;36(5):487-491. doi:10.1016/j.jopan.2020.10.004
26. Canakci E, Catak T, Basar HE, et al. Prevalence study for postoperative nausea vomiting: A training hospital example. Niger J Clin Pract. 2021;24(11):1633. doi:10.4103/njcp.njcp_399_20
27. Stephenson SJ, Jiwanmall M, Cherian NE, Kamakshi S, Williams A. Reduction in post-operative nausea and vomiting (PONV) by preoperative risk stratification and adherence to a standardized anti emetic prophylaxis protocol in the day-care surgical population. J Fam Med Prim Care. 2021;10(2):865. doi:10.4103/jfmpc.jfmpc_1692_20
28. McCracken GC, Montgomery J. Postoperative nausea and vomiting after unrestricted clear fluids before day surgery: A retrospective analysis. Eur J Anaesthesiol EJA. 2018;35(5):337. doi:10.1097/EJA.0000000000000760
29. Escalante Romero. M. Postoperative Nausea and Vomiting Reduction Using the Apfel Screening and Treatment Tool. Yüksek Lisans Tezi. California State University; 2022.
30. Palupi I, Suwondo BS. Comparison between the Apfel Score and the Koivuranta Score in Predicting the Occurrence of Postoperative Nausea and Vomiting during General Anesthesia. J Komplikasi Anestesi. 2023;11(1):32-39. doi:10.22146/jka.v11i1.1171.