Brazilian Journal of Anesthesiology
https://app.periodikos.com.br/journal/rba/article/doi/10.1590/S0034-70942009000500006
Brazilian Journal of Anesthesiology
Scientific Article

A abreviação do jejum pré-operatório para duas horas com carboidratos aumenta o risco anestésico?

Does abbreviation of preoperative fasting to two hours with carbohydrates increase the anesthetic risk?

Kátia Gomes Bezerra de Oliveira; Maiumy Balsan; Sérgio de Souza Oliveira; José Eduardo Aguilar-Nascimento

http://dx.doi.org/10.1590/S0034-70942009000500006 Braz J Anesthesiol, vol.59, n5, p.577-584, 2009
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Resumo

JUSTIFICATIVA E OBJETIVOS: O objetivo do presente estudo foi avaliar o surgimento de possíveis complicações anestésicas relacionadas à abreviação do jejum pré-operatório para duas horas com uma solução contendo dextrinomaltose a 12,5% dentro do projeto ACERTO (Aceleração da Recuperação Total Pós-operatória). MÉTODO: Foram avaliados prospectivamente todos os pacientes submetidos a diversas operações sobre o trato digestivo e parede abdominal dentro de um novo protocolo de condutas perioperatórias estabelecidas pelo projeto ACERTO entre agosto de 2005 e dezembro de 2007. Todos receberam o suplemento nutricional (dextrinomaltose a 12,5%) por via oral seis e duas horas antes do procedimento cirúrgico. A coleta de dados foi prospectiva sem o conhecimento dos profissionais do serviço. Observou-se o tempo de jejum pré-operatório e as complicações anestésicas relacionadas ao curto tempo de jejum (broncoaspiração). RESULTADOS: Foram avaliados 375 pacientes, sendo 174 homens (46,4%) e 201 mulheres (53,6%) entre 18 e 90 anos de idade O tempo médio de jejum pré-operatório foi de quatro horas variando de duas a 20 horas. Não houve nenhum caso de broncoaspiração durante os procedimentos. O tempo de jejum foi maior (p < 0,01) quando se praticou procedimento anestésico associado (bloqueio + geral). CONCLUSÕES: A adoção das medidas multidisciplinares perioperatórias do projeto ACERTO não trouxe nenhuma complicação relacionada ao jejum pré-operatório. A dextrinomaltose é suplemento nutricional útil e seguro para o paciente.

Palavras-chave

ANESTESIA, COMPLICAÇÕES, JEJUM

Abstract

BACKGROUND AND OBJECTIVES: 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. METHODS: 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. RESULTS: 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. CONCLUSIONS: 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.

Keywords

ANESTHESIA, COMPLICATIONS, FASTING

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