Preoperative fasting abbreviation (Enhanced Recovery After Surgery protocol) and effects on the metabolism of patients undergoing gynecological surgeries under spinal anesthesia: A randomized clinical trial.

Abstract

OBJECTIVES:

Recommended perioperative nutritional interventions may contribute to satisfactory surgical outcomes. Each moment in the course of a surgical pathologic condition may be a window of opportunity for an intervention with a positive impact on postoperative recovery. Based on the idea of accelerating postoperative recovery, the objective of this study was to evaluate the effectiveness of a nutritional intervention with preoperative fasting abbreviation (Enhanced Recovery After Surgery recommendations) on the metabolism of patients undergoing gynecologic surgeries under spinal anesthesia.

METHODS:

This randomized clinical trial was performed at a hospital of medium complexity. After Human Research Ethics Committee approval on August 24, 2015, 80 women who had gynecologic surgery in the period from January to June 2016 and signed the consent form were randomly allocated into two groups: a control group (n = 42) and a juice group (n = 38). They received 200 mL of inert solution (control group) or liquid enriched with carbohydrate and protein (juice group) 4 h before surgery. The variables studied were serum glucose, insulin, insulin resistance evaluated by the homeostatic model assessment of insulin resistance (HOMA-IR), C-reactive protein, and albumin in the pre- and postoperative periods. The statistical analysis was performed with SPSS 20.0.

RESULTS:

There was a statistically significant difference in the coefficient of variation for the HOMA-IR index in the control group (17.27%; P < 0.01) compared with the juice group (8.46%; P < 0.05), which remained stable from the pre- to the postoperative period.

CONCLUSIONS:

Preoperative fasting abbreviation with liquid containing carbohydrate and protein before gynecologic surgeries may provide metabolic stability with lower variation in insulin resistance than inert solution.

• Authors: Gisele Vissoci Marquini, Francisco Edes da Silva Pinheiro, Alfredo Urbano da Costa Vieira, Rogério Melo da Costa Pinto, Maria Gabriela Baumgarten Kuster Uyeda, Manoel João Batista Castello Girão, Marair Gracio Ferreira Sartori
• Journal: Nutrition (Burbank, Los Angeles County, Calif.) (Nutrition) Vol. 77 Pg. 110790 (09 2020) ISSN: 1873-1244 [Electronic] United States
• PMID: 32438301 (Publication Type: Clinical Trial Protocol, Journal Article)
• Copyright: Copyright © 2020 Elsevier Inc. All rights reserved.

Topics

• Anesthesia, Spinal
• Enhanced Recovery After Surgery
• Fasting
• Female
• Gynecologic Surgical Procedures
• Humans
• Insulin Resistance
• Preoperative Care
• Randomized Controlled Trials as Topic