Key result
Preoperative fasting information reaches only ~63% of elective surgical patients, indicating suboptimal guideline adherence.
Why the study?
Pulmonary aspiration is a rare but catastrophic anesthesia-related complication in surgical patients, and the practice of aspiration prevention and prophylaxis prior to surgery needed assessment.
What is the practice of preoperative preventive measures for pulmonary aspiration in surgical patients?
Cross-Sectional (n=200)
What is the practice of preoperative preventive measures for pulmonary aspiration in surgical patients?
The practice of preoperative fasting and prophylactic agent administration for pulmonary aspiration is suboptimal and lacks adherence to ASA and ESA recommendations.
May indicate gaps in aspiration prophylaxis guideline adherence; hypothesis-generating for targeted quality improvement before practice change.
Background Pulmonary aspiration of gastric contents is a rare but catastrophic cause of anesthesia related morbidity and mortality of surgical patients. The risk of pulmonary aspiration is high in surgical patient due to multiple factors. The aim of this study was to assess the practice of aspiration prevention and prophylaxis usage for patients prior to surgery. Method A cross-sectional study was conducted from 10 April 2022 to 20 April 2022. Data were collected by the direct observation and patient interview. The standards were directly changed in to questionnaire form with two integral components ‘yes’ and ‘no”. Data were entered and analyzed using statistical package of social sciences (SPSS) version 20. Result A total of 200 surgical patients were included with a response rate of 100%. Preoperative information provision to elective surgical patients on fasting requirements and the reason for them in advance of their procedures was implemented in 63% of the patients. The verification of fasting requirement was provided in 94% of elective patients. About 62.5% of elective surgical patients received gastrointestinal stimulants preoperatively. Metoclopromide was administered for 94% of emergency patients. Conclusion and recommendation The practice of preoperative fasting and administration of prophylactic agents for pulmonary aspiration is quite limited in our setup. Moreover, adherence to the recommendations of American Society of Anesthesiologist (ASA) and European Society of Anesthesiologist (ESA) was also suboptimal. We strongly recommend clinicians to use appropriate prophylactic agent to the right patient and adherence of the clinician to the local guideline on prevention of pulmonary aspiration. Highlights
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Admass et al. (2023) conducted a cross-sectional in Surgical patients at risk of pulmonary aspiration (n=200). Preoperative preventive measures and prophylaxis was evaluated on Practice of aspiration prevention and prophylaxis usage. Preoperative fasting information was provided to 63% of elective surgical patients, and 62.5% received gastrointestinal stimulants, indicating suboptimal adherence to ASA and ESA recommendations.
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