Pre-Operative Fasting: Why Abbreviate?

Abstract

Introduction : Considering the practice of preoperative fasting based on observations on the gastric emptying delay after induction and the time of this fast is closely linked to organic response to trauma, arise the question about preoperative fasting period necessary to minimize such response and support the professional with clinical and scientific evidence. Aim : To review the aspects related to the abbreviation of preoperative fasting from the metabolic point of view, physiology of gastric emptying, its clinical benefits and the currently recommendations. Method : Literature review was based on articles and guidelines published in English and Portuguese, without restriction of time until January 2017, in PubMed, SciELO and Cochrane with the descriptors: surgery, preoperative fasting, carbohydrate. From the universe consulted, 31 articles were selected. Results : The literature suggests that the abbreviation of fasting with beverage added carbohydrates until 2 h before surgery, can bring benefits on glycemic and functional parameters, reduces hospitalization, and does not present aspiration risk of healthy patients undergoing elective surgery. Another nutrient that has been added to the carbohydrate solution and has shown promising results is glutamine. Conclusion : The abbreviation of preoperative fasting with enriched beverage with carbohydrates or carbohydrate and glutamine seems to be effective in the care of the surgical patient, optimizing the recovery from of postoperative period.

Should Cleft Surgery Always be Performed During the Matutine Time? Analysis of Early and Late Postoperative Complications in a Cleft Center

“…The necessity to perform surgeries in the afternoon schedule brings the risk of dehydration due to long fasting periods. Numerous research on the topic (Campos et al, 2018) has proved that several metabolic disturbances occur as the fasting period increases (catabolic state, insulin resistance, proteolysis, and lipolysis). Our current strategy for these patients is to diminish the fasting time by providing liquid intake until 2 hours before the procedure.…”

Pós-operatório de paciente oncológico em jejum prolongado: diagnósticos e intervenções de enfermagem

“…Ainda no âmbito da nutrição, os níveis glicêmicos são marcadores de grande estima para avaliação de pacientes no perioperatório, sendo demonstrado em estudos que o metabolismo da glicose sofre ampla modificação. Ainda que, no presente estudo, a população avaliada manifestou majoritariamente hipoglicemia como complicação pósoperatória, alguns estudos relacionam também o desenvolvimento da hiperglicemia com desencadeamento favorecido pelo jejum prolongado 5,11 . Portanto, no contexto pós-operatório é de grande valia o norteamento através do diagnóstico Risco de glicemia instável, sendo tal fato reforçado em estudo semelhante no qual houve concordância de 80% entre avaliadores de um material teórico voltado para diagnósticos de enfermagem no período perioperatório 20 .…”

“…Neste contexto, a nutrição do paciente no perioperatório vem sendo amplamente discutida, uma vez que autores apresentam o paradoxo gerado pelo benefício do jejum, como por exemplo a prevenção da broncoaspiração durante o efeito anestésico e os impactos negativos gerados para recuperação cirúrgica, como o estresse metabólico 5,6 .…”

Conhecimento sobre angiografia e níveis de ansiedade em pacientes no período pré-cateterismo

“…(35,1%), "Incapaz de relaxar" (35,1%), "Instável" (37,8%), "Assustado" (43,2%) e "Medo do pior acontecer" (43,2% [22].…”