Trial reportBMC anesthesiology2021
Quality-improvement project to reduce actual fasting times for fluids and solids before induction of anaesthesia.
Trial report in BMC anesthesiology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
19 citing papers in PubMed, 1 synthesis or guideline pooled it, 30 citations in OpenAlex.
- Peri-operative fasting in adults: an international, multidisciplinary consensus statement.Anaesthesia · 2026Pooled it
- [International multidisciplinary consensus statement on perioperative fasting in adults].Die Ophthalmologie · 2026Article
- [International multidisciplinary consensus statement on perioperative fasting in adults].Urologie (Heidelberg, Germany) · 2026Review
- [International multidisciplinary consensus statement on perioperative fasting in adults].Die Anaesthesiologie · 2026Review
- 2026 ESAIC Guidelines on preoperative fasting in adults: clinical practice guidelines protocol with EAES participation.European journal of anaesthesiology and intensive care · 2026Article
- Impact of Shorter Preoperative Fluid Fasting on Patient Outcomes: A Safe Brain Initiative Retrospective Cohort Analysis.Anesthesia and analgesia · 2026Observational
- True Preoperative Liquid Fasting in Romania-A Secondary Analysis of the Thirst Study.Nutrients · 2026Observational
- Drink lemonade! Implementation of drinking 2 h before elective orthopedic surgery to reduce prolonged fasting.Nutrition in clinical practice : official publication of the American Society for Parenteral and Enteral Nutrition · 2025Article
- Feasibility and Safety of Liberal Fluid Fasting in an Orthogeriatric Department: A Prospective Before-and-After Cohort Study.Journal of clinical medicine · 2025Article
- Fasting is not always good: perioperative fasting leads to pronounced ketone body production in patients treated with SGLT2 inhibitors: a case report.Korean journal of family medicine · 2025Article
- Patient safety in anaesthesia: the European Patient Safety Foundation and the German Coalition for Patient Safety 'Fasting Cards' initiative.British journal of anaesthesia · 2025Article
- Ultrasound Evaluation of Gastric Emptying and Comparison with Patient-Reported Risk Factors in Elective Surgical Patients.Journal of clinical medicine · 2025Article
- Review
- Impact of preoperative carbohydrate loading on postoperative course and morbidity in debulking surgery for epithelial ovarian cancer.Experimental and therapeutic medicine · 2024Article
- Preoperative clear fluids fasting times in children: retrospective analysis of actual times and complications after the implementation of 1-h clear fasting.Journal of anesthesia, analgesia and critical care · 2024Article
- Randomized controlled trial of liberal vs. standard fasting instructions in percutaneous cardiac procedures.Perioperative medicine (London, England) · 2023Article
- [Preoperative fasting in children-Experiences with implementing a liberal fasting policy].Die Anaesthesiologie · 2023Article
- Effect of total fasting hours on the overall quality of recovery after surgery: An observational study.Saudi journal of anaesthesiaArticle
- Actual Preoperative Fasting Duration and its Impact on Hunger, Thirst, Blood Glucose, and Parental Satisfaction in Pediatric Patients: A Prospective Observational Study.Journal of Indian Association of Pediatric SurgeonsArticle
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundDespite well-defined recommendations, prolonged fasting times for clear fluids and solids are still common before elective surgery in adults. Extended fasting times may lead to discomfort, thirst, hunger and physiological dysfunctions. Previous studies have shown that prolonged fasting times are frequently caused by patients being misinformed as well as inadequate implementation of the current guidelines by medical staff. This study aimed to explore how long elective surgery patients fast in a German secondary care hospital before and after the introduction of an educational note for patients and re-training for the medical staff.
methodsA total of 1002 patients were enrolled in this prospective, non-randomised interventional study. According to the power calculation, in the first part of the study actual fasting times for clear fluids and solids were documented in 502 consecutive patients, verbally instructed as usual regarding the recommended fasting times for clear fluids (2 h) and solids (6 h). Subsequently, we implemented additionally to the verbal instruction a written educational note for the patients, including the recommended fasting times. Furthermore, the medical staff was re-trained regarding the fasting times using emails, newsletters and employee meetings. Thereafter, another 500 patients were included in the study. We hypothesised, that after these quality improvement procedures, actual fasting times for clear fluids and solids would be more accurate on time.
resultsActual fasting times for clear fluids were in the median 11.3 (interquartile range 6.8-14.3; range 1.5-25.5) h pre-intervention, and were significantly reduced to 5.0 (3.0-7.2; 1.5-19.8) h after the intervention (median difference (95%CI) - 5.5 (- 6.0 to - 5.0) h). The actual fasting times for solids also decreased significantly, but only from 14.5 (12.1-17.2; 5.4-48.0) h to 14.0 (12.0-16.3; 5.4-32.0) h after the interventions (median difference (95%CI) - 0.52 (- 1.0 to - 0.07) h).
conclusionsThe study showed considerably extended actual fasting times in elective adult surgical patients, which were significantly reduced by simple educational/training interventions. However, the actual fasting times still remained considerably longer than defined in recommended guidelines, meaning further process optimisations like obligatory fluid intake in the early morning are necessary to improve patient comfort and safety in future.
trial registrationGerman registry of clinical studies (DRKS-ID: DRKS 00020530 , retrospectively registered).
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.