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A retrospective audit of fasting practices pre and post head and neck cancer surgery at a regional centre – preliminary findings


Authors: Deirdre O'Neill,Emma Clifford,Fionnuala Muldoon,Grace Duffy,Grainne McCarthy,Orla McMahon,Patrick Sheahan
Publication: Journal of The Irish Head and Neck Society - 2023
Issue: 1 Volume: 1
Published: June, 2023 View PDF

Background: International guidelines for surgery recommend that perioperative fasting from midnight is unnecessary in most patients. Those with no specific risk of aspiration can drink clear fluids until 2 hours(h) pre op and solids 6h pre op. Evidence is emerging for pre-operative carbohydrate loading in head and neck cancer (HNC). This study will establish the timeframe patients with HNC are fasting pre-surgery and the timeframe until commencement of enteral or oral nutrition. Association with nutritional status, post op complications and length of stay will also be examined.

Methods: Data were collected from medical charts of all patients that had major HNC surgery from June 2021 to June 2022 at SIVUH.

Preliminary Results: Forty patients were included in this study. Mean length of time fasting pre-operatively was 12.6 h. Mean timeframe to commencement of enteral feeding from beginning of surgery was 29.4h. Total fasting time therefore was 42h. Average weight loss during admission was 1.3kg (1.6% weight loss). Post op complications were also recorded – gastrointestinal complications 29/39 (74%), poor wound healing 18/39 (46%), average length of stay (LOS) was 41 days (10-149days).

Conclusion: Once statistical analysis is completed, our findings will investigate whether length of time fasting impacts outcomes. This may also influence the development of a perioperative HNC surgery nutrition protocol.

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