Turkiye Klinikleri Journal of Nursing Sciences

.: ORIGINAL RESEARCH
Ürolojik Cerrahi Girişim Uygulanan Hastalarda Ameliyat Öncesi Açlık Süresi İle Ameliyat Sonrası İyileşme Kalitesi Arasındaki İlişkinin Belirlenmesi: Tanımlayıcı Çalışma
Determination of the Relationship Between Preoperative Fasting Time and Postoperative Recovery Quality in Patients Undergoing Urological Surgery: A Descriptive Study
Hatice DEMİRDAĞa , Hatice ÖNER CENGİZb , Büşra ERDOĞANc , Ece Sümeyra SOYTÜRKd , Batuhan KURTa , Alime Nur UYGUNe
aÜsküdar Üniversitesi Sağlık Bilimleri Fakültesi, Hemşirelik Bölümü, İstanbul, Türkiye
bAnkara Üniversitesi Hemşirelik Fakültesi, Cerrahi Hastalıklar Hemşireliği ABD, Ankara, Türkiye
cAcıbadem Altunizade Hastanesi, İstanbul, Türkiye
dDr. Siyami Ersek Göğüs Kalp ve Damar Cerrahisi Eğitim ve Araştırma Hastanesi, İstanbul, Türkiye
eÜmraniye Eğitim ve Araştırma Hastanesi, İstanbul, Türkiye
Turkiye Klinikleri J Nurs Sci. 2024;16(1):17-25
doi: 10.5336/nurses.2023-100158
Article Language: TR
Full Text
ÖZET
Amaç: Ürolojik cerrahi girişim uygulanacak hastaların ameliyat öncesi dönemde belirli bir süre aç kalmaları sağlanmaktadır. Ancak, açlık sürelerinin uzaması ameliyat sonrası bazı komplikasyonların ortaya çıkmasına neden olabilmektedir. Bu çalışmanın amacı, ürolojik cerrahi girişim uygulanan hastaların ameliyat öncesi açlık süreleri ile ameliyat sonrası iyileşme kalitesi arasındaki ilişkiyi belirlemektir. Gereç ve Yöntemler: Araştırma, 1 Haziran-1 Kasım 2022 tarihleri arasında bir eğitim ve araştırma hastanesinin üroloji kliniğinde yatan hastalarla tanımlayıcı olarak gerçekleştirildi. Verilerin analizinde sayı, yüzde, ortalama ve standart sapma değerleri, Independent Sample ttest, varyans analizi testi ve Pearson korelasyon kullanıldı. Bulgular: Hastaların yaş ortalaması 55,01±14,91 olup, %68,6'sı erkek idi. Hastaların ameliyat öncesi katı ve sıvı gıda açlık süresi ortalamalarının sırasıyla 12,92±2,56 ve 12,47±2,70, ameliyat öncesi ve sonrası toplam açlık süresi ortalamalarının ise 20,46±4,73 olduğu saptandı. Hastaların iyileşme kalitesi toplam puan ortalamasının 174,74±17,93, toplam açlık süresi ile İyileşme Kalitesi Ölçeği toplam puan ortalamaları arasında negatif yönde zayıf bir ilişki olduğu belirlendi (r=-0,34, p<0,05). Toplam açlık süresi ortalamalarına göre hastanede yatış süreleri arasında istatistiksel olarak anlamlı düzeyde fark olduğu (p<0,05), farkın 3 gün ve üzerinde yatan hastaların açlık süresi ortalamalarından (24,88±5,53) kaynaklandığı belirlendi. Hastaların ameliyat öncesi ve sonrası toplam açlık süresi ortalamaları ile ilk mobilize olma saati ortalamaları arasında pozitif yönlü zayıf ilişki olduğu belirlendi (r=0,42, p<0,05). Sonuç: Hastaların ameliyat öncesi katı ve sıvı açlık süreleri ile iyileşme kalitesi arasında ilişki olmadığı ancak, ameliyat öncesi ve sonrası toplam açlık süreleri ile iyileşme kalitesi arasında negatif yönde ilişki olduğu saptanmıştır. Ameliyat öncesi dönemin yanı sıra ameliyat sonrası oral alım kısıtlama sürelerinin de gözden geçirilmesi önerilebilir.

Anahtar Kelimeler: Açlık; ameliyat öncesi dönem; cerrahi sonrası hızlandırılmış iyileşme; ürolojik cerrahi işlemler; perioperatif hemşirelik
ABSTRACT
Objective: Patients undergoing urological surgery are fasted for a certain period of time in the preoperative period. However, prolonged fasting periods may cause some postoperative complications. The aim of this study was to determine the relationship between preoperative fasting periods and postoperative recovery quality in patients undergoing urological surgery. Material and Methods: The descriptive study was conducted with patients hospitalized in the urology clinic of a training and research hospital between 1 June and 1 November 2022. Number, percentage, mean and Standard deviation values, Independent Sample t-test, analysis of variance test, and Pearson correlation were used to analyze the data. Results: The mean age of the patients was 55.01±14.91 years and 68.6% were male. The mean preoperative solid and liquid food fasting duration was 12.92±2.56 and 12.47±2.70, respectively, and the mean preoperative and postoperative total fasting duration was 20.46±4.73. It was determined that the mean total recovery quality score of the patients was 174.74±17.93, and there was a weak negative correlation between total fasting time and total recovery Quality Scale Score (r=-0.34, p<0.05). It was determined that there was a statistically significant difference between the duration of hospitalization according to the mean total fasting time (p<0.05), and the difference was due to the mean fasting time of patients hospitalized for 3 days or more (24.88±5.53). There was a weak positive correlation between the mean preoperative and postoperative total fasting time and the mean time of first mobilization (r=0.42, p<0.05). Conclusion: It was found that there was no relationship between preoperative solid and liquid fasting periods and quality of recovery, but there was a negative relationship between preoperative and postoperative total fasting periods and quality of recovery. It may be recommended to review the preoperative period as well as postoperative oral intake restriction periods.

Keywords: Fasting; preoperative period; accelerated recovery after surgery; urological surgical procedures; perioperative nursing
REFERENCES:
  1. Bayramoğlu BG, Akyüz N. Investigation of preoperative fasting time and preoperative and postoperative well-being of patients. Florence Nightingale J Nurs. 2022;30(1):33-9. [Crossref]  [PubMed]  [PMC] 
  2. Demirdağ H, Karaöz S. Ameliyat öncesi besin/sıvı kısıtlamasına ilişkin hastaların deneyimleri ve hemşirelerin konu ile ilgili bilgi ve uygulamaları [Patients experiences about preoperative fasting and nurses knowledge and practice]. Florence Nightingale Journal of Nursing. 2015;23(1):1-10. [Crossref] 
  3. Rattanapittayaporn L, Oofuvong M, Tanasansuttiporn J, Chanchayanon T. Preoperative fasting of more than 14 hours increases the risk of time-to-death after cardiothoracic surgery in children: a retrospective cohort study. Congenital Heart Disease. 2023;18(1):23-9. [Crossref] 
  4. Yilmaz M, Çelik M. The effects of preoperative fasting on patients undergoing thoracic surgery. J Perianesth Nurs. 2021;36(2):167-73. Erratum in: J Perianesth Nurs. 2021;36(1):95. [Crossref]  [PubMed] 
  5. Li J, Wang Y, Xiao Y, Bai F, Xie H, Wang K, et al. Effect of different preoperative fasting time on safety and postoperative complications of painless gastrointestinal endoscopy for polyps in patients. Am J Transl Res. 2021;13(7):8471-9. [PubMed]  [PMC] 
  6. Gul A, Andsoy II, Ozkaya B. Preoperative fasting and patients' discomfort. Indian Journal of Surgery. 2018;80:549-53. [Crossref] 
  7. Taniguchi H, Ushigome K. Minimizing the length of the preoperative fasting period to prevent stress and dehydration. In: Fukushima R, Kaibori M, eds. Enhanced Recovery After Surgery. Singapore: Springer; 2018. p.13-20. [Crossref] 
  8. Marquini GV, da Silva Pinheiro FE, da Costa Vieira AU, da Costa Pinto RM, Kuster Uyeda MGB, Girão MJBC, et al. Preoperative fasting abbreviation (Enhanced Recovery After Surgery protocol) and effects on the metabolism of patients undergoing gynecological surgeries under spinal anesthesia: a randomized clinical trial. Nutrition. 2020;77:110790. [Crossref]  [PubMed] 
  9. Wendler E, Nassif PAN, Malafaia O, Brites Neto JL, Ribeiro JGA, Proença LB, et al. Shorten preoperative fasting and introducing early eating assistance in recovery after gastrojejunal bypass? Arq Bras Cir Dig. 2022;34(3):e1606. [Crossref]  [PubMed]  [PMC] 
  10. Liang Y, Yan X, Liao Y. The effect of shortening the preoperative fasting period on patient comfort and gastrointestinal function after elective laparoscopic surgery. Am J Transl Res. 2021;13(11):13067-75. [PubMed]  [PMC] 
  11. Ajuzieogu OV, Amucheazi AO, Nwagha UI, Ezike HA, Luka SK, Abam DS. Effect of routine preoperative fasting on residual gastric volume and acid in patients undergoing myomectomy. Niger J Clin Pract. 2016;19(6):816-20. [Crossref]  [PubMed] 
  12. Alsharkh WS, Aljuaid M, Huda AU, Bawazir A, Alharbi A, Alharbi N. Effect of total fasting hours on the overall quality of recovery after surgery: an observational study. Saudi J Anaesth. 2023;17(3):373-7. [Crossref]  [PubMed]  [PMC] 
  13. Fekede MS, Abebe BA, Awol MA. Assessment of adherence to preoperative fasting guidelines and associated patient discomfort in adult elective surgical patients in public hospitals of Addis Ababa, Ethiopia: a multicenter cross-sectional study. IJS Short Reports. 2022;7(4):e60. [Crossref] 
  14. He Y, Wang R, Wang F, Chen L, Shang T, Zheng L. The clinical effect and safety of new preoperative fasting time guidelines for elective surgery: a systematic review and meta-analysis. Gland Surg. 2022;11(3):563-75. [Crossref]  [PubMed]  [PMC] 
  15. De Jonghe B, Fajardy A, Mérian-Brosse L, Fauconnier A, Chouillard E, Debit N, et al. Reducing pre-operative fasting while preserving operating room scheduling flexibility: feasibility and impact on patient discomfort. Acta Anaesthesiol Scand. 2016;60(9):1222-9. [Crossref]  [PubMed] 
  16. Thomas T. Comparison of ultrasonographic gastric content and volume in patients posted for elective surgery with preoperative fasting for different durations. Indian Journal of Anaesthesia. 2022;66(Suppl 1): S67. [PMC] 
  17. 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 Task Force on Preoperative Fasting and the Use of Pharmacologic Agents to Reduce the Risk of Pulmonary Aspiration. Anesthesiology. 2017;126(3):376-93. [Crossref]  [PubMed] 
  18. Türk Anesteziyoloji ve Reanimasyon Derneği. Preoperative Değerlendirme Anestezi Uygulama Kılavuzları. 2015. [Link] 
  19. van Noort HHJ, Eskes AM, Vermeulen H, Besselink MG, Moeling M, Ubbink DT, et al. Fasting habits over a 10-year period: An observational study on adherence to preoperative fasting and postoperative restoration of oral intake in 2 Dutch hospitals. Surgery. 2021;170(2):532-40. [Crossref]  [PubMed] 
  20. El-Sharkawy AM, Daliya P, Lewis-Lloyd C, Adiamah A, Malcolm FL, Boyd-Carson H, et al; FaST Audit Group; East Midlands Surgical Academic Network (EMSAN). Fasting and surgery timing (FaST) audit. Clin Nutr. 2021;40(3):1405-12. [Crossref]  [PubMed]  [PMC] 
  21. Rızalar S, Aydemir A, Topçu SY. Cerrahi hastalarının ameliyat öncesi ve sonrasında açlık ve susuzluk düzeylerinin incelenmesi [Examination of hunger and thirst levels of surgical patients before and after surgery]. Sağlık ve Yaşam Bilimleri Dergisi. 2019;1(2):32-6. [Crossref] 
  22. Vukovic N, Dinic L. Enhanced recovery after surgery protocols in major urologic surgery. Front Med (Lausanne). 2018;5:93. [Crossref]  [PubMed]  [PMC] 
  23. Karaveli Çakır S, Yavuz Van Gıersbergen M, Çakır Umar D. Cerrahi hemşirelerinin ameliyat öncesi aç kalma ile ilgili uygulama ve bilgi düzeyi [Surgery nurses' knowledge and practice about preoperative fasting]. Ege Üniversitesi Hemşirelik Fakültesi Dergisi. 2018;34(1):26-35. [Link] 
  24. Raosoft [Internet]. © 2004 by Raosoft, Inc. [Cited: 20.06.2019]. Raosoft sample size calculator. Available from: [Link] 
  25. Myles PS, Weitkamp B, Jones K, Melick J, Hensen S. Validity and reliability of a postoperative quality of recovery score: the QoR-40. Br J Anaesth. 2000;84(1):11-5. [Crossref]  [PubMed] 
  26. Karaman S, Arici S, Dogru S, Karaman T, Tapar H, Kaya Z, et al. Validation of the Turkish version of the quality of recovery-40 questionnaire. Health Qual Life Outcomes. 2014;12:8. [Crossref]  [PubMed]  [PMC] 
  27. George D, Mallery P. SPSS for Windows Step by step: A Simple Guide and Reference. 10th ed. USA: Allyn & Bacon, Inc.; 2010.
  28. Bölükbaş N, Birlikbaş S. ERAS rehberleri cerrahi sonrası hızlandırılmış iyileşme protokolleri [Enhanced recovery after surgery]. Ordu Üniversitesi Hemşirelik Çalışmaları Dergisi. 2019;2(3):194-205. [Link] 
  29. Ruth MS, Josephine MS, Williams A. Preoperative fasting in the day care patient population at a tertiary care, teaching institute: a prospective, cross-sectional study. CHRISMED Journal of Health and Research. 2018;5(2):105-9. [Crossref] 
  30. Li Y, Lu Q, Wang B, Tang W, Fan L, Li D. Preoperative fasting times for patients undergoing elective surgery at a pediatric hospital in shanghai: the big evidence-practice gap. J Perianesth Nurs. 2021;36(5):559-63. [Crossref]  [PubMed] 
  31. Rodrigues Pessoa R, Urkmez A, Kukreja N, Baack Kukreja J. Enhanced recovery after surgery review and urology applications in 2020. BJUI Compass. 2020;1(1):5-14. [Crossref]  [PubMed]  [PMC] 
  32. Carmichael L, Rocca R, Laing E, Ashford P, Collins J, Jackson L, et al. Early postoperative feeding following surgery for upper gastrointestinal cancer: a systematic review. J Hum Nutr Diet. 2022;35(1):33-48. [Crossref]  [PubMed] 

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