title: Reducing pre-operative fasting while preserving operating room scheduling flexibility: feasibility and impact on patient discomfort.
abstract: BACKGROUND
  The need to preserve operating room (OR) scheduling flexibility can challenge adherence to the 2-h pre-operative fasting period recommendation before elective surgery. Our primary objective was to assess the feasibility of a pre-operative carbohydrate (CHO) drink delivery strategy preserving OR scheduling flexibility.
  
  
  METHODS
  During the 1st study phase, patients admitted for elective surgery fasted overnight (Control group); during the 2nd phase, patients fasted overnight and received a pre-operative CHO drink (CHO group). CHO delivery time was set to allow any patient to be ready for surgery 30 min ahead of the scheduled time and any patient with an operation scheduled in the afternoon to be ready at 13:00 hours; patients admitted the morning of an early morning operation would not be allowed to take a CHO drink.
  
  
  RESULTS
  We included 194 patients in the Control group and 199 in the CHO group. In the CHO group, the morning CHO dose was delivered to 66.3% of the patients (95% CI 59.3-72.9%), with a median pre-operative fasting time period of 4 h 57 min. After excluding patients admitted the morning of an operation scheduled before 10:00 hours, the delivery rate was 77.2% (70.2-83.3%). Patients in the CHO group experienced significantly less pre-operative thirst (median 2 vs. 5 on a 0-10 scale, P < 0.0001) and hunger (0 vs. 2, P < 0.0001) than those in the Control group.
  
  
  CONCLUSIONS
  Although preservation of OR scheduling flexibility resulted in a longer fasting time than recommended, CHO drink can be made available to a large proportion of patients with significantly reduced perioperative discomfort.
authors.affiliation: Centre Hospitalier de Poissy-Saint-Germain, Poissy, France.
authors.forename: B
authors.initials: B
authors.lastname: De Jonghe
authors.affiliation: Centre Hospitalier de Poissy-Saint-Germain, Poissy, France.
authors.forename: A
authors.initials: A
authors.lastname: Fajardy
authors.affiliation: Centre Hospitalier de Poissy-Saint-Germain, Poissy, France.
authors.forename: L
authors.initials: L
authors.lastname: Mérian-Brosse
authors.affiliation: Centre Hospitalier de Poissy-Saint-Germain, Poissy, France.
authors.forename: A
authors.initials: A
authors.lastname: Fauconnier
authors.affiliation: Centre Hospitalier de Poissy-Saint-Germain, Poissy, France.
authors.forename: E
authors.initials: E
authors.lastname: Chouillard
authors.affiliation: Centre Hospitalier de Poissy-Saint-Germain, Poissy, France.
authors.forename: N
authors.initials: N
authors.lastname: Debit
authors.affiliation: Centre Hospitalier de Poissy-Saint-Germain, Poissy, France.
authors.forename: H
authors.initials: H
authors.lastname: Solus
authors.affiliation: Centre Hospitalier de Poissy-Saint-Germain, Poissy, France.
authors.forename: N
authors.initials: N
authors.lastname: Tabary
authors.affiliation: Centre Hospitalier de Poissy-Saint-Germain, Poissy, France.
authors.forename: J-C
authors.initials: JC
authors.lastname: Séguier
authors.affiliation: Hôpital Raymond Poincaré, APHP, Garches, France.|Faculté de Médecine PIFO, Versailles, France.
authors.forename: J-C
authors.initials: JC
authors.lastname: Melchior
mesh_terms: D000328:Adult; D000368:Aged; D004326:Drinking; D017558:Elective Surgical Procedures; D005215:Fasting; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009873:Operating Rooms; D010561:Personnel Staffing and Scheduling; D011300:Preoperative Care; D013997:Time Factors