Relationship Between Preoperative Fasting Duration and Anxiety Levels With Postoperative Pain, Nausea-Vomiting, and Sleep Quality in Orthopedic Surgical Patients: A Cross-Sectional Study.

Cross-sectional design can show associations but cannot prove that longer fasting causes more anxiety or that anxiety causes more pain or vomiting. It used a non-probability volunteer sample from one hospital and only planned orthopedic surgery in Turkish citizens, so results may not apply to other surgical patients or settings. Patients with diagnosed cognitive, psychiatric, neurological, or sleep disorders, or those using medication for these conditions, were excluded, so results may not apply to those groups. Pain, nausea, anxiety, and sleep were measured by patient self-report, and no preoperative sleep quality or preoperative pain severity was assessed. Nausea and vomiting were uncommon after the first hour, and the authors noted the institution had effective postoperative nausea and vomiting management, which limits how much these outcomes could vary. The regression models explained limited variance: 9.7% for pain and 19.5% for sleep quality. All patients received general anesthesia under standardized protocols, and perioperative opioid use was recorded for 188 patients, so the findings do not separate the effects of fasting, anxiety, anesthesia, opioids, or analgesic timing.

The authors declared no conflicts of interest. The funding statement named Türkiye Bilimsel ve Teknolojik Araştırma Kurumu.

Do not conclude that shortening preoperative fasting will reduce anxiety, pain, vomiting, or improve sleep. The study was cross-sectional and showed associations; fasting variables were not significant predictors of pain or sleep in the regression models.