Preoperative carbohydrate treatment for enhancing recovery after elective surgery

Enhanced Recovery After Surgery (ERAS) for gastrointestinal surgery, part 1: pathophysiological considerations

“…This allows for better use of any nutritional care post‐operatively, with less risk of hyperglycaemia and improved retention of protein and preservation of lean body mass 40. Studies conducted in relatively small patient populations suggested better outcomes with pre‐operative complex carbohydrates given orally up to 2 h before anaesthesia and surgery,41, 42 However, a meta‐analysis43 and a recent Cochrane analysis44 of all available data from randomised controlled trials suggest that in major abdominal surgery there is clinical impact as evidenced by faster recovery43, 44 (reduced length of stay by 1–1.5 days43). However, for minor surgery the benefit is mainly in patient well‐being,41 and in other types of surgeries the data remain sparse 44.…”

“…Studies conducted in relatively small patient populations suggested better outcomes with pre‐operative complex carbohydrates given orally up to 2 h before anaesthesia and surgery,41, 42 However, a meta‐analysis43 and a recent Cochrane analysis44 of all available data from randomised controlled trials suggest that in major abdominal surgery there is clinical impact as evidenced by faster recovery43, 44 (reduced length of stay by 1–1.5 days43). However, for minor surgery the benefit is mainly in patient well‐being,41 and in other types of surgeries the data remain sparse 44. Many National and International Anaesthetic Societies recommend a 6‐h pre‐operative fast for solids and a 2‐h fast for clear liquids, including carbohydrate drinks 44, 45, 46, 47…”

“…However, for minor surgery the benefit is mainly in patient well‐being,41 and in other types of surgeries the data remain sparse 44. Many National and International Anaesthetic Societies recommend a 6‐h pre‐operative fast for solids and a 2‐h fast for clear liquids, including carbohydrate drinks 44, 45, 46, 47…”

It is time for enhanced recovery after surgery in cardiac surgery

“…The avant-garde preparation for surgery is to administer cooled down fluids until the evening of the day preceding the surgical procedure, and on the surgery day maintaining a 2-h withdrawal period before wheeling the patient to the operating room [38]. The objective is to maintain normovolaemia on admitting the patient to the operating suite [39].…”

Programa de auxílio para alimentação de adultos hospitalizados: estudo quase-experimental

“…Estudo realizado por Azambuja et al 11 avaliou, a partir de registros da enfermagem, que apenas 39,8% dos pacientes cirúrgicos apresentam boa aceitação da alimentação por via oral. Sabe-se que o jejum prolongado, efeitos da anestesia e complicações cirúrgicas pós-operatórias podem contribuir para a ocorrência de náuseas e vômitos e consequentemente configurar-se como um dos fatores que prejudicam a alimentação por via oral 12 .…”