Efeitos da abreviação do tempo de jejum pré-operatório na função respiratória e muscular de pacientes submetidos a colecistectomia via laparotomia

Abstract

The abbreviation of preoperative fasting with carbohydrate (CHO) rich beverage promotes important benefits for surgical patients with enhanced postoperative recovery. Objectives: To evaluate changes in pulmonary function and hand grip strength depending on the type of submitted fasting (shortened or conventional) after cholecystectomy performed by laparotomy. Methods: This is an experimental prospective randomized clinical study including 92 female patients undergoing open cholecystectomy. They were randomized to conventional (8h) or shortened fasting (2h). We measured the values of forced vital capacity (FVC), forced expiratory volume in the first second (FEV1), peak expiratory flow (PEF), dominant hand grip strength (FPPd) and nondominant hand grip strength (FPPnd) at the preoperative period and 24 hours after the surgery. Results: There was no difference between the two groups in terms of demographics and clinical characteristics. However, spirometric values such as FVC (2,3 ± 1,8 vs. 1.1 ± 0.9; p = 0.021), FEV1 (1.5 ± 0.6 x 1.2 ± 0.5; p = 0.040) and FPPd (24.9 ± 6.8 x 18.4 ± 7.7; p = 0.001) and FPPnd (22.9 ±6.3 x 17.0 ± 7.8) were significantly higher in the intervention group at the postoperative period and there was no difference between the values of pre and postoperative to FPPd (25.2 ± 6.7 x 24.9 ± 6.8, p = 0, 692). Conclusion: The abbreviation of preoperative fast to 2h with CHO-based beverage preserves FPPd and enhances both pulmonary and muscle function.