Effect of shortening perioperative fasting time on rapid recovery of thyroid surgery

Objective To explore the effect of shortening preoperative fasting time on rapid recovery of thyroid surgery. Methods A total of 120 cases of patients who underwent thyroid cancer surgery in our hospital from June to December 2016 were selected and divided into observation group and control group according to the operating time sequence, 60 cases in each group. In the control group, patients were undergoing routine fasting 12 h and forbidden to drink 10 h before surgery, they were allowed to eat if backward choking did happen when they drank 6 h after surgery. In the observation group, according to the theory of fast-track surgery, patients were forbidden to eat 6 h and to drink 4 h before surgery, they were allowed to eat if backward choking did happen when they drank 4 h after surgery. The levels of cortisol and blood sugar in peripheral blood of the two groups were measured one day before operation, during operation and one day after operation. The stress reaction during the observation period was analyzed by χ² test, t test and F test. Results There was no significant difference in intraoperative vomiting/aspiration[0(0.00%)vs. 0(0.00%)], postoperative nausea[7 (11.67%) vs. 5 (8.33%)] and vomiting[3 (5.00%) vs. 4 (6.67%)] between the two groups (χ²=0.370, 0.152, all P>0.05). The incidence of thirst and hunger in the observation group[3 (5.00%), 2 (3.33%)] was lower than those in the control group[55 (91.67%), 58 (96.67%)] before and after operation, and postoperative hospital stay[(5.1±1.3) d] was less than that of the control group[(6.3±1.1) d], with the statistically significant difference (χ²=90.234, 104.530, t=5.165, all P<0.05). The intraoperative cortisol levels in the observation group[(493.6±116.7) ng/L] was significantly lower than that in the control group[(548.1±116.4) ng/L, t=2.327, P<0.05]. The level of cortisol in peripheral blood of the observation group[(500.2±121.3) ng/L] was significantly lower than that of the control group[(592.4±119.2) ng/L] one day after operation (t=2.906, P<0.05). One day after operation, the fasting blood glucose in the observation group[(5.5±0.8 mmol/L] was significantly lower than that in the control group[(7.3±1.0) mmol/L, t=10.887, P<0.05]. Conclusion It is safe and feasible to shorten the fasting time during thyroid cancer surgery in the theory of fast-track surgery, which not only can reduce the discomfort of patients and promote the early recovery of the patients, but also shorten the length of hospital stay. At the same time, it provides evidence for experts of thyroid and further the process of the use of FTS in thyroid disease.