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Ameliyat öncesi aç kalma: Sistematik derleme

Yıl 2018, , 183 - 194, 14.05.2018
https://doi.org/10.5505/ptd.2017.50490

Öz

Amac: Bu derlemenin amacı, ameliyat öncesi aç kalma ile ilgili randomize
kontrollü çalışmaları değerlendirmektir.

Gerec ve Yöntem: Ameliyat öncesi aç kalma ile ilgili randomize kontrollü
çalışmalar incelendi. Bu literatur incelemesi bilgisayar ortamında “Pubmed”,
“EBSCO”, “Med-LINE” ve “SCOPUS”, veritabanları kullanılarak yapıldı. Ameliyat
öncesi aç kalma ile ilgili randomize kontrolllü 11 (on bir) makale bulundu. Bu
11 (on bir) çalışma kronolojik sıraya göre, amaç, örneklem, yöntem, bulgular,
tartışma ve sonuçları içeren bir düzen içerisinde verildi.

Bulgular: Ameliyat öncesi aç kalma ile ilgili 11 (on bir) çalışma, ameliyat
öncesi hastaların gece yarısından sonra tamamen aç kalmaları, ameliyat öncesi
aç kalma sürelerinin kısaltılması ve bu sürede verilen farklı içerikte, aynı
hacimdeki sıvıların, ameliyattan sonraki süreç (kan şekeri, insülin düzeyi,
albümin düzeyi ve hastanede kalış sürelerini vb) üzerine etkileri ile ilgili
sonuçları içermektedir. Literatürde ameliyat öncesi uzun süreli açlığın, bir
çok metabolik değişikliklerin ortaya çıkmasına neden olduğu, hastaların
stresini arttırdığı, uyumunu bozduğu, hastanede kalış süresini arttırdığı ve
hastaların konforunu azalttığı belirtilmektedir. Ameliyat öncesi açlık
süresinin kısaltılmasının gastrointestinal sistem fonksiyonları üzerine olumsuz
etkisi belirlenmiştir.

Sonuç: Geleneksel olarak uygulanan gece boyu açlık ve sonuçları artık sorgulanmaktadır.


Bu konuyla ilgili özellikle değişen koşulların değerlendirilmesi için daha
geniş örneklemler üzerinde ileri çalışmalara ihtiyaç olduğu düşünülmektedir.

Türkçe Kısa Başlık: Ameliyat öncesi aç kalma



Kaynakça

  • 1. Yıldız H. Preoperatif açlık sürecinde yeni yaklaşımlar: new approaches durıng preoperatıve poverty process. AÜTD /MJAU 2006; 38:1-5.
  • 2. Yılmaz E. Cerrahi hastalarda ameliyat öncesi açlık sürecinde yeni yaklaşımlar. Ege Üniversitesi Hemşirelik Yüksek Okulu Dergisi 2009; 25:105-118.
  • 3. Yağcı G, Can MF. Evidence-Based value of preoperative oral carbohydrate loading; ameliyat öncesi karbonhidrat yüklemesinin kanıta dayalı değeri. Anestezi Dergisi 2008;16:69-79. 4. Dolgun E, Taşdemir N, Ter N, Yavuz M. Investigation of preoperative fasting times of surgical patients. F.Ü.Sağ.Bil.Tıp Derg 2011;25:11-15.
  • 5. Hausel J, Nygren J, Thorell A, Lagerkranser M, Ljungqvist O. Clinical trial of the effects of oral preoperative carbohydrates on postoperative nausea and vomiting after laparoscopic cholecystectomy. Br J Surg 2005;92:415–421.
  • 6. Machado PA, de Oliveira, BD, Dock-Nascimento DB, de Aguilar-Nascimento JE, Shrinking preoperative fast time with maltodextrin and protein hydrolysate in gastrointestinal resections due to cancer. Nutrition 2013;29:1054-1059.
  • 7. Gül A, Andsoy II, Üstündağ H, Özkaya BÖ. Assessment of preoperative fasting time in elective general surgery. JMHM 2013;1:1-8.
  • 8. Noblett SE, Watson DS, Huong H, Davison B, Hainsworth PJ, Horgan AF. Pre-operative oral carbohydrate loading in colorectal surgery: a randomized controlled trial. Colorectal Dis 2006;8:563–569.
  • 9. Dolgun E. Ameliyat öncesi aç kalma zamanı, 8. Ulusal cerrahi ve ameliyathane hemşireleri kongresi özet kitabı. Kuşadası/ Aydın:2014;17-24.
  • 10. Perioperative fasting in adults and children – a RCN guideline for the multidisciplinary team. Clinical practice guidelines, RCN publications 2005.
  • 11. Søreide E, Eriksson L I, Hirlekar G et al. Task Force on Scandinavian Preoperative Fasting Guidelines, Clinical Practice Committee Scandinavian Society of Anaesthesiology and Intensive Care Medicine-SSAI). Preoperative fasting guidelines: an update. Acta Anaesthesiol Scand 2005;49:1041-1047.
  • 12. Smith I, Kranke P, Murat I et al. Perioperative fasting in adults and children: guidelines from the European Society of Anaesthesiology (ESA). European Journal of Anaesthesiology (EJA) 2011; 28.8: 556-569.
  • 13. American Society of Anaesthesiologist task force on preoperative fasting. Practice guidelines for preoperative fasting and the use of pharmacologic agents to reduce the risk of pulmonary aspiration: application to healthy patients undergoing elective procedures: an updated report by the American Society of Anaesthesiologists Committee on standards and practice parameters. Anaesthesiology 2011;114(3)495-511.
  • 14. Türk Anesteziyoloji ve Reanimasyon Derneği (TARD) Anestezi Uygulama Kılavuzları Preoperatif Değerlendirme 2015.
  • 15. Australian and New Zealand College of Anaesthetists (ANZCA) Guidelines on Pre-Anaesthesia Consultation and Patient Preparation 2016.
  • 16. Practice Guidelines for Preoperative Fasting and the Use of Pharmacologic Agents to Reduce the Risk of Pulmonary Aspiration: Application to Healthy Patients. Undergoing Elective Procedures: An Updated Report by the American Society of Anesthesiologists (ASA). Task Force on Preoperative Fasting and the Use of Pharmacologic Agents to Reduce the Risk of Pulmonary Aspiration. Anesthesiology 2017; 126:376-93.
  • 17. Weimann A, Braga M, Carli F et al. ESPEN guideline: Clinical nutrition in surgery. Clinical Nutrition 2017;36: 623-650.
  • 18. Yagci G, Can MF, Özturk E et al. 2008. Effects of preoperative carbohydrate loading on glucose metabolism and gastric contents in patients undergoing moderate surgery: A randomized, controlled trial. Nutrition 2008;24:212–216.
  • 19. Marcelo FN, de Aguilar-Nascimento JE, Pimenta OS et al. Preoperative fasting of 2 hours minimizes insulin resistance and organic response to trauma after video-cholecystectomy: A randomized, controlled, clinical trial. World J Surg 2009;33:1158-1164.
  • 20. Kaška M, Grosmanová T, Havel E et al. The impact and safety of preoperative oral or intravenous carbohydrate administration versus fasting in colorectal surgery – a randomized controlled trial. Wien Klin Wochenschr 2010;122: 23–30.
  • 21. Ayoğlu H, Uçan B, Öge Taşçılar Ö, Atik L, Kaptan YM, Turan IÖ. Preoperatif oral karbonhidrat solüsyonu kullanılmasının hasta anksiyetesi ve konforu üzerine etkileri, Türk Anest Rean Der Dergisi 2009;37:374-382.
  • 22. Mathur S, Plank LD, McCall JL et al. Randomized controlled trial of preoperative oral carbohydrate treatment in major abdominal surgery. Br J Surg 2010;97:485–94.
  • 23. Ljunggren S, Hahn RG. Oral nutrition or water loading before hiprepla cement surgery; a randomized clinical trial. Trials 2012;13:1-11.
  • 24. Yurtcu M, Gunel E, Sahin TK, Sivrikaya A, Effects of fasting and preoperative feeding in children. World J Gastroenterol 2009;15:4919-4922.
  • 25. de Andrade Gagheggi Ravanini G, Portari Filho PE, Abrantes Luna R et al. Organic inflammatory response to reduced preoperative fasting time, with a carbohydrate and protein enriched solution; a randomized trial. Nutr Hosp 2015;32;2:953-957.

Preoperative fasting: A systematic review.

Yıl 2018, , 183 - 194, 14.05.2018
https://doi.org/10.5505/ptd.2017.50490

Öz

Aim: The aim of this compilation is to evaluate the randomized controlled studies made about preoperative fasting. 
Material and Method: Randomized controlled studies about preoperative fasting were examined. This literature examination was made in computer environment by using “Pubmed”, “EBSCO”, “Med-LINE” ve “SCOPUS” databases. 11 randomized controlled papers were found about preoperative fasting. These 11 studies were given in an order according to chronological order including aim, sample, method, findings, discussion and conclusions. 
Findings: 11 studies about preoperative fasting include results about complete preoperative fasting of patients after midnight, reducing preoperative fasting periods and the effect of liquids given to patients during this process at same volume and different content, on the situation (blood sugar level, insulin level, albumin level and staying period in hospital) after operation. In literature it was stated that long term fasting causes many metabolic changes to occur, that it increases stress level of patients, that it damages their accordance, that it increases the staying period in hospital and that it decreases the comfort of patients. No negative impact of reduced preoperative fasting period could be detected on gastro intestinal system functions. 
Conclusion: Night time fasting, which is a traditional application and its results, is now being questioned. Related with this issue, it is considered that studies on wider samples are required in order to evaluate the changing conditions. 

İngilizce Kısa Başlık: Preoperative fasting

Kaynakça

  • 1. Yıldız H. Preoperatif açlık sürecinde yeni yaklaşımlar: new approaches durıng preoperatıve poverty process. AÜTD /MJAU 2006; 38:1-5.
  • 2. Yılmaz E. Cerrahi hastalarda ameliyat öncesi açlık sürecinde yeni yaklaşımlar. Ege Üniversitesi Hemşirelik Yüksek Okulu Dergisi 2009; 25:105-118.
  • 3. Yağcı G, Can MF. Evidence-Based value of preoperative oral carbohydrate loading; ameliyat öncesi karbonhidrat yüklemesinin kanıta dayalı değeri. Anestezi Dergisi 2008;16:69-79. 4. Dolgun E, Taşdemir N, Ter N, Yavuz M. Investigation of preoperative fasting times of surgical patients. F.Ü.Sağ.Bil.Tıp Derg 2011;25:11-15.
  • 5. Hausel J, Nygren J, Thorell A, Lagerkranser M, Ljungqvist O. Clinical trial of the effects of oral preoperative carbohydrates on postoperative nausea and vomiting after laparoscopic cholecystectomy. Br J Surg 2005;92:415–421.
  • 6. Machado PA, de Oliveira, BD, Dock-Nascimento DB, de Aguilar-Nascimento JE, Shrinking preoperative fast time with maltodextrin and protein hydrolysate in gastrointestinal resections due to cancer. Nutrition 2013;29:1054-1059.
  • 7. Gül A, Andsoy II, Üstündağ H, Özkaya BÖ. Assessment of preoperative fasting time in elective general surgery. JMHM 2013;1:1-8.
  • 8. Noblett SE, Watson DS, Huong H, Davison B, Hainsworth PJ, Horgan AF. Pre-operative oral carbohydrate loading in colorectal surgery: a randomized controlled trial. Colorectal Dis 2006;8:563–569.
  • 9. Dolgun E. Ameliyat öncesi aç kalma zamanı, 8. Ulusal cerrahi ve ameliyathane hemşireleri kongresi özet kitabı. Kuşadası/ Aydın:2014;17-24.
  • 10. Perioperative fasting in adults and children – a RCN guideline for the multidisciplinary team. Clinical practice guidelines, RCN publications 2005.
  • 11. Søreide E, Eriksson L I, Hirlekar G et al. Task Force on Scandinavian Preoperative Fasting Guidelines, Clinical Practice Committee Scandinavian Society of Anaesthesiology and Intensive Care Medicine-SSAI). Preoperative fasting guidelines: an update. Acta Anaesthesiol Scand 2005;49:1041-1047.
  • 12. Smith I, Kranke P, Murat I et al. Perioperative fasting in adults and children: guidelines from the European Society of Anaesthesiology (ESA). European Journal of Anaesthesiology (EJA) 2011; 28.8: 556-569.
  • 13. American Society of Anaesthesiologist task force on preoperative fasting. Practice guidelines for preoperative fasting and the use of pharmacologic agents to reduce the risk of pulmonary aspiration: application to healthy patients undergoing elective procedures: an updated report by the American Society of Anaesthesiologists Committee on standards and practice parameters. Anaesthesiology 2011;114(3)495-511.
  • 14. Türk Anesteziyoloji ve Reanimasyon Derneği (TARD) Anestezi Uygulama Kılavuzları Preoperatif Değerlendirme 2015.
  • 15. Australian and New Zealand College of Anaesthetists (ANZCA) Guidelines on Pre-Anaesthesia Consultation and Patient Preparation 2016.
  • 16. Practice Guidelines for Preoperative Fasting and the Use of Pharmacologic Agents to Reduce the Risk of Pulmonary Aspiration: Application to Healthy Patients. Undergoing Elective Procedures: An Updated Report by the American Society of Anesthesiologists (ASA). Task Force on Preoperative Fasting and the Use of Pharmacologic Agents to Reduce the Risk of Pulmonary Aspiration. Anesthesiology 2017; 126:376-93.
  • 17. Weimann A, Braga M, Carli F et al. ESPEN guideline: Clinical nutrition in surgery. Clinical Nutrition 2017;36: 623-650.
  • 18. Yagci G, Can MF, Özturk E et al. 2008. Effects of preoperative carbohydrate loading on glucose metabolism and gastric contents in patients undergoing moderate surgery: A randomized, controlled trial. Nutrition 2008;24:212–216.
  • 19. Marcelo FN, de Aguilar-Nascimento JE, Pimenta OS et al. Preoperative fasting of 2 hours minimizes insulin resistance and organic response to trauma after video-cholecystectomy: A randomized, controlled, clinical trial. World J Surg 2009;33:1158-1164.
  • 20. Kaška M, Grosmanová T, Havel E et al. The impact and safety of preoperative oral or intravenous carbohydrate administration versus fasting in colorectal surgery – a randomized controlled trial. Wien Klin Wochenschr 2010;122: 23–30.
  • 21. Ayoğlu H, Uçan B, Öge Taşçılar Ö, Atik L, Kaptan YM, Turan IÖ. Preoperatif oral karbonhidrat solüsyonu kullanılmasının hasta anksiyetesi ve konforu üzerine etkileri, Türk Anest Rean Der Dergisi 2009;37:374-382.
  • 22. Mathur S, Plank LD, McCall JL et al. Randomized controlled trial of preoperative oral carbohydrate treatment in major abdominal surgery. Br J Surg 2010;97:485–94.
  • 23. Ljunggren S, Hahn RG. Oral nutrition or water loading before hiprepla cement surgery; a randomized clinical trial. Trials 2012;13:1-11.
  • 24. Yurtcu M, Gunel E, Sahin TK, Sivrikaya A, Effects of fasting and preoperative feeding in children. World J Gastroenterol 2009;15:4919-4922.
  • 25. de Andrade Gagheggi Ravanini G, Portari Filho PE, Abrantes Luna R et al. Organic inflammatory response to reduced preoperative fasting time, with a carbohydrate and protein enriched solution; a randomized trial. Nutr Hosp 2015;32;2:953-957.
Toplam 24 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Konular Klinik Tıp Bilimleri
Bölüm Derleme
Yazarlar

Fadime Gök

Yayımlanma Tarihi 14 Mayıs 2018
Gönderilme Tarihi 6 Haziran 2017
Kabul Tarihi 24 Aralık 2017
Yayımlandığı Sayı Yıl 2018

Kaynak Göster

AMA Gök F. Ameliyat öncesi aç kalma: Sistematik derleme. Pam Tıp Derg. Mayıs 2018;11(2):183-194. doi:10.5505/ptd.2017.50490

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