Starving for Surgery: An Integrative Review

Background: Perioperative Fasting, or NPO (nil per os) status is a widespread preprocedural order to prevent intraoperative aspiration. “NPO” refers to the time a patient is without any oral liquids or solids before a procedure. In most healthcare settings, NPO after midnight is common practice. However, numerous evidence-based studies suggest the routine of prolonged NPO leads to numerous adverse side effects and surgical complications. Purpose: The purpose of this integrative literature review was to synthesize and evaluate studies to determine the extent of preoperative fasting implemented with adult patients undergoing elective procedures. Moreover, the timing of how soon before a procedure can a patient safely consume oral liquids or solids was examined. Methods: A search of the literature was conducted, using CINAHL, Pubmed, and Google Scholar. The search resulted in twenty-three articles relevant and advantageous for the purpose of this review. Results: Three themes commonly found in the articles include: 1) Patients are fasting longer than guidelines recommend, 2) patients allowed preoperative intake 2 hours prior to surgery experienced less preoperative and postoperative hunger and thirst, nausea and vomiting, and surgical complications, 3) postoperative hospital stay increases with increased preoperative fasting time. Keywords: NPO, Perioperative fasting, Pulmonary Aspiration Risks, Patient Comfort, Fasting; guidelinesBachelor of Scienc