this guideline reflects the recommendations of the group of specialists of the Brazilian College of Surgeons , the Brazilian Society of Parenteral and Enteral Nutrition and the ACERTO Project for nutritional interventions in the perioperative period of Elective General Surgery .
The prescription of these recommendations can accelerate the postoperative recovery of patients su bmi tted to elective general surgery , with decrease in morbidity , length of stay and rehospitalization , and consequently , of costs
OBJECTIVE to present recommendations based on the ACERTO Project ( Acceleration of Total Post-Operative Recovery ) and supported by evidence related to perioperative nutritional care in General Surgery elective procedures .
Safety and efficacy of oral rehydration therapy until 2 h before surgery: a multicenter randomized controlled trial
Purpose In many countries , patients are generally allowed to have clear fluids until 2–3 h before surgery . In Japan , long preoperative fasting is still common practice . To shorten the preoperative fasting period in Japan , we tested the safety and efficacy of oral rehydration therapy until 2 h before surgery . Methods Three hundred low-risk patients scheduled for morning surgery in six university-affiliated hospitals were r and omly assigned to an oral rehydration solution ( ORS ) group or to a fasting group . Patients in the ORS group consumed up to 1,000 ml of ORS containing balanced glucose and electrolytes : 500 ml between 2100 the night before surgery and the time they woke up the next morning and 500 ml during the morning of surgery until 2 h before surgery . Patients in the fasting group started fasting at 2100 the night before surgery . Primary endpoints were gastric fluid volume and pH immediately after anesthesia induction . Several physiological measures of hydration and electrolytes including the fractional excretion of sodium ( FENa ) and the fractional excretion of urea nitrogen ( FEUN ) were also evaluated . Results Mean ( SD ) gastric fluid volume immediately after anesthesia induction was 15.1 ( 14.0 ) ml in the ORS group and 17.5 ( 23.2 ) ml in the fasting group ( P = 0.30 ) . The mean difference between the ORS group and fasting group was −2.5 ml . The 95 % confidence interval ranged from −7.1 to + 2.2 ml and did not include the noninferior limit of + 8 ml . Mean ( SD ) gastric fluid pH was 2.1 ( 1.9 ) in the ORS group and 2.2 ( 2.0 ) in the fasting group ( P = 0.59 ) . In the ORS group , mean FENa and FEUN immediately after anesthesia induction were both significantly greater than those in the fasting group ( P < 0.001 for both variables ) . The ORS group reported they had been less thirsty and hungry before surgery ( P < 0.001 , 0.01 ) . Conclusions Oral rehydration therapy until 2 h before surgery is safe and feasible in the low-risk Japanese surgical population . Physicians are encouraged to use this practice to maintain the amount of water in the body and electrolytes and to improve the patient ’s comfort
this guideline reflects the recommendations of the group of specialists of the Brazilian College of Surgeons , the Brazilian Society of Parenteral and Enteral Nutrition and the ACERTO Project for nutritional interventions in the perioperative period of Elective General Surgery .
The prescription of these recommendations can accelerate the postoperative recovery of patients su bmi tted to elective general surgery , with decrease in morbidity , length of stay and rehospitalization , and consequently , of costs
OBJECTIVE to present recommendations based on the ACERTO Project ( Acceleration of Total Post-Operative Recovery ) and supported by evidence related to perioperative nutritional care in General Surgery elective procedures .