A cross sectional, observational study to evaluate the surgeons’ knowledge and perspective on preoperative fasting guidelines in a tertiary care teaching hospital in Southern India

Background and Aims: The preoperative fasting orders given by the Anesthesiologists as per ASA and Enhanced Recovery After Surgery protocol, are often modified by the surgeons, for practical convenience, which can end up with patients being starved for prolonged periods of time. Hence, this study was conducted among various specialty surgical colleagues, to evaluate the knowledge and their perspective regarding patients’ preoperative fasting guidelines. Material and Methods: A validated questionnaire was distributed to 68 surgeons belonging to various surgical specialties, which included consultants and postgraduate residents. The surgeons were grouped as surgeons operating only on children, only on adults, and on adults and children (mixed). Data were summarized using the mean (SD)/median for continuous variables and categorical data were expressed as frequency and percentage. The difference in knowledge score, among the surgeons of three groups, was analyzed using ANOVA, with Bonferroni as post hoc. Results: This study shows an overall decrease in knowledge (score of 6.13 ± 1.74) about preoperative fasting guidelines among surgeons. We found that the level of knowledge about preoperative fasting guidelines and complications was higher among surgeons who operate only on children (score of 7.05) as compared to surgeons operating only on adults (score 5.5) and adults and children (mixed) (score 6.1), which was statistically significant ( P = 0.013). We found no difference in knowledge level based on designation and gender. All the surgeons uniformly had the perspective that patients have to be kept fasting preoperatively. Conclusion: Preoperative fasting orders for all surgical patients, especially for vulnerable patients such as children and geriatrics, should be administered by the anesthesiologist or surgeon who is familiar with fasting guidelines. We intend to raise the awareness of fasting guidelines of surgical colleagues by putting up placards and posters in the wards.