Evaluation of the Effect of APFEL Risk Score and Fasting Times on Postoperative Nausea and/or Vomiting

Öz

Objective: Postoperative nausea and vomiting (PONV) occurs in 30-80% of elective surgeries depending on the method of anesthesia, type of surgery and patient characteristics. It has been shown that prolonged preoperative fasting may increase rather than prevent complications. The aim of this study was to determine the relationship between APFEL risk score and duration of fasting and development of PONV. Methods: A descriptive and observational study. This study was conducted between February and December 2023 in 321 patients scheduled for elective surgery at a university and a state hospital. Inclusion criteria included being over 18 years of age, having an ASA (American Society of Anesthesiologists) score between I-III, and voluntary participation in the study. Data were collected using the “Personal Information Form”, “APFEL Risk Score” and “Post Operative Nausea and Vomiting Assessment Form”. Statistical analyses were performed with IBM SPSS Statistics 27 program and p<0.05 was considered significant. Results: The mean age of the patients was 46.75±16.88 years and 53.9% were female. The mean duration of solid food fasting was 15.59±15.86 hours and the mean duration of liquid food fasting was 11.49±5.03 hours. APFEL risk score of 2 was found in 33.3% of the participants. A statistically significant correlation was found between APFEL risk score, solid and liquid fasting times and ASPC (p<0.05). Patients who underwent gastrointestinal surgery had significantly longer fasting times (p<0.05). Conclusion: APFEL risk score and fasting periods were found to be effective in the development of PONV. Appropriate regulation of preoperative fasting times may reduce the risk of PONV.

Anahtar Kelimeler

• Apfel Risk Score
• Nursing
• Preoperative Fasting
• Postoperative Nausea and Vomiting

Apfel Risk Skoru ve Açlık Sürelerinin Ameliyat Sonrası Bulantı ve/veya Kusmaya Etkisinin Değerlendirilmesi

Öz

Amaç: Ameliyat sonrası bulantı ve kusma (ASBK), elektif cerrahilerde anestezi yöntemi, cerrahi tipi ve hasta özelliklerine bağlı olarak %30-80 oranında görülmektedir. Ameliyat öncesi uzun süreli açlık uygulamalarının komplikasyonları önlemek yerine artırabileceği gösterilmiştir. Bu çalışmanın amacı, APFEL risk skoru ve açlık süreleri ile ASBK gelişimi arasındaki ilişkiyi belirlemektir. Metod: Tanımlayıcı ve gözlemsel bir çalışmadır. Bu çalışma Şubat-Aralık 2023 tarihleri arasında bir üniversite ve bir devlet hastanesinde elektif cerrahi planlanan 321 hasta üzerinde yürütülmüştür. Dahil edilme kriterleri arasında 18 yaş üstü olmak, ASA (American Society of Anesthesiologists) skoru I-III arasında bulunmak ve çalışmaya gönüllü katılım yer almaktadır. Veriler “Bireysel Bilgi Formu”, “APFEL Risk Skoru” ve “Ameliyat Sonrası Bulantı ve Kusma Değerlendirme Formu” ile toplanmıştır. İstatistiksel analizler IBM SPSS Statistics 27 programı ile gerçekleştirilmiş, p<0,05 değeri anlamlı kabul edilmiştir. Bulgular: Hastaların yaş ortalaması 46,75±16,88 olup, %53,9'u kadındır. Katı gıda açlık süresi ortalama 15,59±15,86 saat, sıvı gıda açlık süresi ise 11,49±5,03 saattir. Katılımcıların %33,3’ünde APFEL risk skoru 2 bulunmuştur. APFEL risk skoru, katı ve sıvı açlık süreleri ile ASBK arasında istatistiksel olarak anlamlı ilişki tespit edilmiştir (p<0,05). Gastrointestinal cerrahi geçiren hastaların açlık süreleri anlamlı olarak daha uzundur (p<0,05). Sonuç: APFEL risk skoru ve açlık süreleri ASBK gelişiminde etkili bulunmuştur. Ameliyat öncesi açlık sürelerinin uygun şekilde düzenlenmesi ASBK riskini azaltabilir.

Anahtar Kelimeler

• Ameliyat Öncesi Açlık
• Ameliyat Sonrası Bulantı Kusma
• Apfel Risk Skoru
• Hemşirelik

Kaynakça

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