Association of prolonged preoperative fasting with post-operative nausea and vomiting in patients of orthopaedic surgeries undergoing General Anaesthesia
Keywords:
Preoperative fasting, Postoperative nausea and vomiting, General anesthesia, Orthopedic surgery, Observational studyAbstract
Background: Excessive preoperative fasting remains common despite guidance permitting clear liquids until two hours before elective anesthesia. Its association with postoperative nausea and vomiting (PONV) may be influenced by established risk factors. Objective: To assess the association between prolonged preoperative fasting and PONV among patients undergoing elective orthopedic surgery under general anesthesia. Methods: This single-center observational comparative study included 68 purposively sampled patients aged at least 17 years with ASA physical status I-II. Fasting was classified as 6-8 hours or >8 hours, and PONV was assessed within 24 hours. Crude risk ratios (RRs), 95% confidence intervals (CIs), and Fisher exact p-values were derived from the reported contingency tables. Results: PONV occurred in 24 patients (35.3%): 20/34 fasting >8 hours (58.8%) and 4/34 fasting 6-8 hours (11.8%), giving a crude RR of 5.00 (95% CI 1.91-13.09; p<0.001) and an absolute risk difference of 47.1 percentage points (95% CI 27.3-66.8). PONV was more frequent among females than males (53.6% vs 22.5%; RR 2.38, 95% CI 1.22-4.64; p=0.011). Age and ASA differences were not significant. Conclusion: Fasting >8 hours was strongly associated with PONV, but residual confounding and the inability to separate solid- and clear-fluid fasting prevent causal interpretation. Keywords: preoperative fasting, postoperative nausea and vomiting, general anesthesia, orthopedic surgery, observational study
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