Objective To explore the practical effects of action research on the management of preoperative fasting and fluid restriction in day surgery patients. MethodsA convenience sampling method was used to select day surgery patients who underwent day surgery at the Day Surgery Center of West China Hospital of Sichuan University between May 2022 and May 2024. According to the admission time, patients were divided into control group, first cycle group, and second cycle group. The effects of the preoperative fasting and fluid restriction management plan were observed based on the implementation of two rounds of action plans. Results A total of 567 patients were included. Among them, there were 186 cases in the control group, 190 cases in the first cycle group, and 191 cases in the second cycle group. There was no statistically significant difference in general information among the three groups of patients (P>0.05). After implementing the initiative to reduce preoperative fasting durations, the median preoperative fasting time for day surgery patients in the second cycle group was 4.41 (3.13, 6.12) hours, which represented a significant reduction compared to 13.72 (10.83, 16.40) hours in the control group and 6.42 (4.53, 9.60) hours in the first cycle group (P<0.05). Although the fasting duration did not significantly decrease among the three groups, the morning feeding rates for patients in the first and second cycle showed a slight increase compared to the control group. Conclusions Through the implementation of a preoperative fasting and fluid restriction management protocol, the preoperative fluid restriction duration for day surgery patients has been significantly reduced. This aligns with the principles of enhanced recovery after surgery. Moreover, the incidence of intraoperative aspiration and postoperative nausea and vomiting did not show a significant increase. Action research offers crucial theoretical and practical support for the efficient and scientific implementation of preoperative fasting and fluid restriction management.
Objective To investigate the efficacy of dietary management based on the principles of enhanced recovery after surgery (ERAS) in bowel preparation for patients undergoing colonoscopy. Methods Patients undergoing colonoscopy procedures in the Department of Gastroenterology at West China Hospital, Sichuan University between December 2023 and December 2024 were randomly assigned to a control group and a trial group. The control group received conventional dietary management, comprising a self-prepared low-residue diet with fasting commencing at 22:00 on the preoperative evening. The trial group received dietary management based on the ERAS protocol, comprising pre-packaged low-residue meals on the day before surgery (lunch, dinner, and a 22:00 snack) plus 200 mL of clear liquids consumed 2 hours preoperatively. The Boston Scale and a subjective experience questionnaire (assessing preoperative and postoperative hunger, thirst, adverse reactions, etc.) were used to evaluate and compare bowel preparation quality and patient subjective experiences between the two groups. Results A total of 370 patients were included, comprising 194 in the control group and 176 in the trial group. Compared with the control group, the trial group showed no statistically significant difference in the Boston score for bowel preparation, the rate of adequate bowel preparation (78.41% vs. 71.65%), or the incidence of adverse reactions during bowel preparation or postoperatively (P>0.05). Patients in the trial group demonstrated higher subjective satisfaction with bowel cleansing (81.82% vs. 68.04%) and lower preoperative hunger [1.00 (0.00, 4.00) vs. 2.00 (0.00, 5.00)], with statistically significant differences (P<0.05). Conclusions Dietary management based on the ERAS concept does not increase the risk of bowel preparation failure or the incidence of adverse reactions during bowel preparation or postoperatively, compared with self-prepared low-residue diets. However, it reduces patients’ preoperative hunger and improves subjective satisfaction with bowel cleansing, making it worthy of promotion and application in clinical practice.