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| Name | Class |
|---|---|
| URC-CIC Paris Descartes Necker Cochin | OTHER |
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The aim of this prospective study was to investigate whether non-fasting recommendation could reduce preoperative anxiety level, incidence of anesthetist interventions, and number of surgical complications in elective cataract surgery patients.
Fear of aspiration makes anesthetists reluctant to challenge standard pre-operative fasting guidelines recommending stopping eating solids and drinking clear fluid 6 hours and 2 hours, respectively before anesthesia. However, hunger and thirst exacerbates patients' anxiety, adversely impacts the patient's comfort and satisfaction, and enhances pain response leading to additional need for analgesia.
Patients undergoing non-invasive procedures requiring no or light sedation may benefit from non-fasting recommendations. The need for preoperative fasting in patients undergoing cataract surgery under topical anesthesia remains controversial. Patients are not fasted before standard cataract surgery under local anesthesia in many cataract centers, in accordance with the UK national guideline published in 2012. However, this practice is not supported by a high level of evidence from prospective clinical trials. So far, the lack of international professional consensus on the matter, local practices are based on institutional recommendations obviating the need for starvation in routine cataract surgery under topical anesthesia.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Non-fasting group | Experimental |
| |
| Fasting group | Experimental |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| State-Trait Anxiety Inventory (STAI) scale | Other | State-Trait Anxiety Inventory (STAI) scale |
|
| Measure | Description | Time Frame |
|---|---|---|
| State-Trait Anxiety Inventory (STAI) scale score | preoperative anxiety level | Baseline (Before surgery) |
| Measure | Description | Time Frame |
|---|---|---|
| Incidence of vitreous outbreaks perceived by the operator | Incidence of vitreous outbreaks perceived by the operator | During surgery |
| Incidence of capsular ruptures | Incidence of capsular ruptures |
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Inclusion Criteria:
Exclusion Criteria:
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Service Anesthésie Réanimation chirurgicale, Hôpital Cochin | Paris | IDF | 75014 | France |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 28652955 | Background | Chon T, Ma A, Mun-Price C. Perioperative Fasting and the Patient Experience. Cureus. 2017 May 24;9(5):e1272. doi: 10.7759/cureus.1272. | |
| 24384865 | Background | Ogino Y, Kakeda T, Nakamura K, Saito S. Dehydration enhances pain-evoked activation in the human brain compared with rehydration. Anesth Analg. 2014 Jun;118(6):1317-25. doi: 10.1213/ANE.0b013e3182a9b028. |
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| ID | Term |
|---|---|
| D001008 | Anxiety Disorders |
| D005215 | Fasting |
| ID | Term |
|---|---|
| D001523 | Mental Disorders |
| D005247 | Feeding Behavior |
| D001519 | Behavior |
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| ID | Term |
|---|---|
| D014894 | Weights and Measures |
| ID | Term |
|---|---|
| D008919 | Investigative Techniques |
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| Satisfaction scale | Other | Satisfaction scale |
|
| During surgery |
| Satisfaction scale score | Satisfaction scale score (scale from 0 to 10) | Immediately after surgery |
| Incidence of oxygen desaturations | Incidence of oxygen desaturations (SpO2 <93%) | During surgery |
| Proportion of patients who took their usual antihypertensive therapy | Proportion of patients who took their usual antihypertensive therapy | Baseline (Before surgery) |
| 8343333 | Background | Maltby JR, Hamilton RC. Preoperative fasting guidelines for cataract surgery under regional anaesthesia. Br J Anaesth. 1993 Jul;71(1):167. doi: 10.1093/bja/71.1.167-a. No abstract available. |
| 11437763 | Background | Steeds C, Mather SJ. Fasting regimens for regional ophthalmic anaesthesia. A survey of members of the British Ophthalmic Anaesthesia Society. Anaesthesia. 2001 Jul;56(7):638-42. doi: 10.1046/j.1365-2044.2001.02116.x. |
| 29863606 | Background | Seet E, Kumar CM, Eke T, Joshi GP. Starving Patients Before Cataract Surgery Under Regional Anesthesia: Needed or Not? Anesth Analg. 2018 Dec;127(6):1448-1451. doi: 10.1213/ANE.0000000000003504. No abstract available. |
| 35911419 | Result | Guerrier G, Bernabei F, Giannaccare G, Vagge A, Bonnet C, Baillard C, Monnet D, Rothschild PR. The StarvAnx Study-Comparison Between the Effects of Non-fasting Vs. Fasting Strategy on Surgical Outcomes, Anxiety and Pain in Patients Undergoing Cataract Surgery Under Topical Anesthesia: A Randomized, Crossover, Controlled Trial. Front Med (Lausanne). 2022 Jul 13;9:916225. doi: 10.3389/fmed.2022.916225. eCollection 2022. |