Efeito da abreviação do jejum pré-operatório na glicemia e no bem-estar pós-operatório de pacientes submetidos à cirurgia cardiovascular: um estudo clínico randomizado, cego e placebo-controle

Abstract

Introduction: Preoperative fasting can contribute to malnutrition and postoperative complications, since it causes an increase in the metabolic response to surgical trauma in patients, being hyperglycemia its main characteristic. The present study aimed to investigate the effect of abbreviation of preoperative fasting on blood glucose and postoperative well-being of patients undergoing cardiovascular surgery. Methods: Clinical, randomised, placebo-control and blind study enrolling 8 patients undergoing cardiovascular surgery. Participants were randomly allocated to one of two groups: treatment (n=4) and control (n=4). The participants in the treatment group received water with tasteless maltodextrin (12.5 g/100 mL) and participants in the control group received only water, 8 hours before surgery (400 mL) and from 2 to 3 hours before surgery (200 mL). Before surgery, demographic and clinical data and fasting blood glucose were assessed. Blood glucose was measured during 24 hours after surgery and well-being of the participants was also investigated on the post-operative. Results: Participants in both groups had two or more risk factors for the development of cardiovascular diseases. Participants in the control group had higher postoperative blood glucose values from 6 hours after surgery and all of them needed insulin correction. Conversely, only one participant in the treatment group needed this correction. Considering the assessment of well-being, the participants in the treatment group showed more positive responses related to the absence of unwanted symptoms resulting from the surgical intervention. Conclusion: Shortened fasting resulted in better glycemic control and comfort for the participants. Implementation of this protocol is safe and had positive outcomes. Even so, further studies are required to support this practice, as introduce an abbreviated fasting protocol is challenging in situations where the prolonged fasting is the established cultural practice.