Abstract

To investigate the effects of preoperative fasting abbreviation with a carbohydrate and protein-enriched solution, on postoperative nausea and vomiting (PONV) incidence in gynecological surgery patients, a population naturally at risk for such unpleasant episodes. The present prospective double-blind randomized study was performed at The Hospital Municipal e Maternidade Dr. Odelmo Leão Carneiro (HMMOLC, in the Portuguese acronym), in Uberlândia, state of Minas Gerais, Brazil, in partnership with the Gynecology Department of the Universidade Federal de São Paulo (UNIFESP), approved by the Human Research Ethics Committee of UNIFESP and the board of HMMOLC, and included in the Brazil Platform and in the Brazilian Clinical Trial Registry. After signing the consent form, 80 women, who were submitted to gynecological surgery in the period from January to June 2016, were randomized into 2 groups: control group (n = 42) and juice group (n = 38). They received, respectively, 200 mL of inert solution or liquid enriched with carbohydrate and protein 4 hours presurgery. The incidence, frequency and intensity of PONV were studied using the Visual Analogue Scale (VAS), with statistical analysis performed by the software IBM SPSS Statistics for Windows, Version 20.0 (IBM Corp, Armonk, NY, USA). The incidence of nausea and vomiting was lower than in the literature, to this population, with 18.9% (14/74) for the control group and 10.8% (8/74) for the juice group, respectively, with no statistically significant difference between the groups. The incidence of nausea and vomiting was lower than in the literature, but it cannot be said that this is due to the abbreviation of fasting. It can provide greater comfort, with the possibility of PONV prevention in patients at risk for these episodes.

Highlights

  • Prevention of postoperative nausea and vomiting (PONV) is recommended by perioperative care protocols, such as Enhanced Recovery After Surgery (ERAS) in Europe and Total Postoperative Recovery Acceleration (ACERTO, in the Portuguese acronym) in Latin America and Brazil, among others, as they are some of the most unpleasant postoperative symptoms

  • The incidence of nausea and vomiting was lower than in the literature, but it cannot be said that this is due to the abbreviation of fasting

  • Resultados A incidência de náuseas e vômitos foi mais baixa que a esperada na literatura para essa população, com 18,9% (14/74) para o grupo controle e 10,8% (8/74) para o grupo suco, respectivamente, sem diferença estatisticamente significante entre os grupos

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Summary

Introduction

Prevention of postoperative nausea and vomiting (PONV) is recommended by perioperative care protocols, such as Enhanced Recovery After Surgery (ERAS) in Europe and Total Postoperative Recovery Acceleration (ACERTO, in the Portuguese acronym) in Latin America and Brazil, among others, as they are some of the most unpleasant postoperative symptoms. They are considered to be the events that can most affect postoperative satisfaction and recovery.[1,2] According to the mentioned perioperative care protocols, the ingestion of a carbohydrateand protein-enriched liquid up to 2 hours before surgery may decrease the incidence of nausea and vomiting.[1,2]. Each criterion receives a point, and the high-risk patients are those with scores > 3 points.[3,4]

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