Oliveira Kátia Gomes Bezerra de, Balsan Maiumy, Oliveira Sérgio de Souza, Aguilar-Nascimento José Eduardo
Departamento de Clínica Cirúrgica, HUJM, UFMT.
Rev Bras Anestesiol. 2009 Sep-Oct;59(5):577-84. doi: 10.1016/s0034-7094(09)70082-0.
The objective of the present study was to evaluate the incidence of possible anesthetic complications related with the abbreviation of preoperative fasting to two hours with a solution of 12.5% dextrinomaltose within the ACERTO (from the Portuguese for Acceleration of Total Postoperative Recovery) project.
All patients undergoing different types of digestive tract and abdominal wall surgeries within a new protocol of perioperative conducts, established by the ACERTO project, between August 2005 and December 2007 were evaluated. All patients received oral nutritional supplementation (12.5% dextrinomaltose) six and two hours before the procedure. Data were collected prospectively without the knowledge of the professionals in the department. The length of preoperative fasting and anesthetic complications related with the short fasting time (pulmonary aspiration) were recorded.
Three hundred and seventy five patients, 174 male (46.4%) and 201 female (53.6%), ages 18 to 90 years, were evaluated. The mean preoperative fasting time was four hours, ranging from two to 20 hours. Pulmonary aspiration was not observed during the procedures. The length of fasting was longer (p < 0.01) when combined anesthesia (blockade + general) was used.
Adopting the multidisciplinary preoperative measures of the ACERTO project was not associated with any preoperative fasting-associated complications. Dextrinomaltose is a useful and safe nutritional supplement for the patient.
本研究的目的是在ACERTO（葡萄牙语，意为加速术后全面恢复）项目中，评估将术前禁食时间缩短至两小时并给予12.5%右旋糖酐麦芽糖溶液可能引发的麻醉并发症发生率。
对2005年8月至2007年12月期间，在ACERTO项目制定的围手术期新方案下接受不同类型消化道和腹壁手术的所有患者进行评估。所有患者在手术前六小时和两小时接受口服营养补充剂（12.5%右旋糖酐麦芽糖）。数据在部门专业人员不知情的情况下进行前瞻性收集。记录术前禁食时间以及与短禁食时间相关的麻醉并发症（肺误吸）。
共评估了375例患者，其中男性174例（46.4%），女性201例（53.6%），年龄在18至90岁之间。术前平均禁食时间为四小时，范围为两至20小时。手术过程中未观察到肺误吸情况。采用联合麻醉（阻滞+全身）时，禁食时间更长（p<0.01）。
采用ACERTO项目的多学科术前措施未出现任何与术前禁食相关的并发症。右旋糖酐麦芽糖对患者而言是一种有用且安全的营养补充剂。
