术前禁食:为何缩短禁食时间?

PRE-OPERATIVE FASTING: WHY ABBREVIATE?

作者信息

Campos Samara Bomfim Gomes, Barros-Neto João Araújo, Guedes Glaucevane da Silva, Moura Fabiana Andréa

机构信息

Faculdade de Nutrição, Universidade Federal de Alagoas, Maceió, AL, Brazil.

出版信息

Arq Bras Cir Dig. 2018;31(2):e1377. doi: 10.1590/0102-672020180001e1377. Epub 2018 Jul 2.

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.

摘要

引言

考虑到基于诱导后胃排空延迟的观察结果进行术前禁食的做法,且这种禁食时间与机体对创伤的反应密切相关,于是出现了关于将术前禁食时间缩短至何种程度以最小化这种反应并为专业人员提供临床和科学证据支持的问题。

目的

从代谢角度、胃排空生理学、其临床益处及当前建议等方面综述与缩短术前禁食相关的内容。

方法

文献综述基于2017年1月前在PubMed、SciELO和Cochrane上发表的英文和葡萄牙文文章及指南,不限时间,检索词为:手术、术前禁食、碳水化合物。从检索到的文献中筛选出31篇文章。

结果

文献表明,术前2小时前饮用含碳水化合物饮料来缩短禁食时间,可在血糖和功能参数方面带来益处,减少住院时间,且对于接受择期手术的健康患者不存在误吸风险。另一种添加到碳水化合物溶液中且已显示出有前景结果的营养素是谷氨酰胺。

结论

用富含碳水化合物或碳水化合物与谷氨酰胺的饮料缩短术前禁食时间,似乎在外科患者护理中有效,可优化术后恢复。

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