Doctors want fasting of surgery patients at Kenya’s top hospital relaxed

By RS Writer

At midnight a nurse will sweep though wards at Kenyatta hospital warning surgery patients not to eat anything until after the operations.

This will trigger a starving marathon that could run for up to 23 hours. But now doctors at Kenyatta say the facility is clinging to an obsolete habit no longer practiced in modern medicine.

In the practice, called Preoperative Fasting (POF), it has been the tradition to have patients starve from midnight until they are operated on.

Reviewing the practice at KNH, an in house team, says this practice had been replaced by progressive international guidelines in 1999. As per the revised guidelines no patient should fast for more than eight hours.

These guidelines allow the consumption of clear liquids up to two hours before elective surgery, a light breakfast six hours before the procedure, and a normal meal eight hours beforehand.

Recently, KNH sponsored an in-house team to assess whether it had stepped into this realm of modern medicine.

The team of George Njoroge, Lucy Kivuti-Bitok and Samuel Kimani of the School of Nursing Sciences, University of Nairobi, and Kenyatta National Hospital, found the hospital to unnecessarily over starve their surgery patients.

At midnight, a patient says, nurses will come around in the wards warning any patient scheduled for the next day not to take any food or liquid before the operation.

The team in a report published last month (12 April 2017) in the International Scholarly Research Notices found majority of patients, 77 per cent fasting for about 15 hours while about 30 per cent did not eat for up to 22 hours.

These findings, the team says are not consistent with the reviewed and acceptable global guidelines. “’This may be due to lack of flexibility and adaptability by the institution to the global trends and development.”

The team was especially surprised that patients for elective surgery could not take clear fluids when thirsty.

“This finding portends lack of knowledge and the inconsistencies associated with the fasting guidelines, since clear liquids are permissible up to two hours before surgery.”

The doctors say the shortened starving period increases patient comfort after surgery, reduce stress and improves how the body responds to the hormone insulin.

The researchers had investigated 65 pre-surgery patients at the hospitals surgical wards between April and July 2015.

The team regrets what it calls resistance to change at the leading training hospital in the country likely to influence medical practice across the country.

The doctors want the midnight ‘no-food’ bulk calls replaced with an approach where patients are approached and advised on their fasting schedules individually.

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