Clinical effects of prolonged preoperative fasting in breast cancer surgery: a prospective cohort study

Preoperative fasting reduce the risk of pulmonary aspiration during induction of anaesthesia. However, scientific documentation on the correlation between prolonged preoperative fasting and patient discomfort is limited. The aim of the present study was to investigate whether the duration of preoperative fasting correlates with pre- and postoperative patient discomfort, the duration of stay at postoperative care unit and the occurrence of surgical complications within 30 days. This prospective observational study included 50 women undergoing elective breast cancer surgery. The Numerical Rating Scale (NRS) was used to assess hunger, thirst, nausea, pain, and anxiety. Patient characteristics, surgical data and occurrence of surgical complications were collected from medical records. Statistical analyses included Sperman’s rank correlation, Pearson’s correlation, Wilcoxon signed rank test, and logistic regression analysis. The mean fasting duration was 15.1 h for solid food and 12.1 h for fluids. A positive association was observed between fasting duration for solid food and nausea prior to surgery (p = 0.067), although not reaching statistical significance. There was no significant correlation between duration of fasting for both solids and fluids and patient discomfort before and after surgery, nor with the duration of stay on the postoperative care unit, nor with the surgical complication rate within 30 days. No correlation was observed between the duration of preoperative fasting and patient discomfort, the length of stay in the postoperative care unit, or the incidence of surgical complications. Notably, fasting durations highly exceeded the recommended six hours for solids and two hours for clear fluids.