Sezaryen Öncesi Açlık Süresinde Kanıta Dayalı Yaklaşım / Evidence Based Approach to Preoperative Fasting Time Before Cesarean Section

Kanıta dayalı uygulamalar klinikte hastalar için en doğru kararı vermede etkili olan uygulamaları içermektedir. Sezaryen öncesi hazırlık sürecinde açlık süresine ilişkin kılavuzlarda çeşitli öneriler ve kanıt düzeyleri mevcuttur. Bu süreçte eski bir uygulama olan nil per os (NPO) yani oral alımın gece yarısından itibaren kısıtlanması yaygın olarak uygulanır. Bu kısıtlamanın amacı aspirasyon ve regurjitasyon gibi anesteziye bağlı komplikasyonları en aza indirmektir. Cerrahi işlemin gecikmesi veya ertelenmesi açlık süresinin daha fazla uzamasına neden olur. Açlık süresinin uzaması ise dehidratasyon, insulin direnci, kaygı ve baş ağrısı gibi olumsuz sonuçlara yol açabilir. Bu olumsuz sonuçları en az düzeye indirmek için cerrahi öncesi açlıkla ilgili güncel kılavuzlar takip edilmelidir. Güncel kılavuzlarda sezaryen öncesi son iki saate kadar sıvı gıda alımına, son 6-8 saate kadar da katı gıda alımına izin verilmektedir. Ebeler başta olmak üzere sezaryen öncesi süreçte gebelere bakım veren sağlık profesyonelleri verilen bakımın kalitesini artırmak için güncel kılavuzları takip etmeli ve önerilere uygun girişimleri benimsemelidir. Bu derlemede sağlık profesyonellerinin konu ile ilgili bilgi düzeylerini arttırmak amacıyla sezaryen öncesi açlık süresinin etkileri, günümüzdeki uygulamalar ve öneriler ele alındı.

Anahtar Kelimeler:

açlık, ameliyat öncesi bakım, kanıta dayalı uygulama, sezaryen

Evidence Based Approach to Preoperative Fasting Time Before Cesarean Section

Evidence-based practices includes the best interventions for the patients. There are some evidences and suggestions about preoperative fasting time before cesarean section. Restricting oral intake of liquids or solids from midnight is an old practice called nil per os (NPO) is widely practiced in clinics. This is used to minimize the complications of anesthesia such as aspiration and regurgitation. When the surgical procedure delayed, fasting period is prolonged. Prolonged fasting times can cause harm effects like dehydration, insulin resistance, anxiety and headache. Current preoperative fasting guidelines and evidence-based practices should be followed to reduce these undesirable effects. Fasting from the intake of clear liquids for two hours; solids for six or eight hours before surgery is suggested in the current guidelines. Health professionals especially midwives who give care for women before cesarean section, should follow the current guidelines to increase the quality of healthcare. In this review, the effects of the pre-cesarean fasting period, current practices and recommendations were discussed in order to increase the knowledge level of health professionals.

Keywords:

fasting, preoperative care, evidence-based practice, cesarean section,

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