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CC BY 4.0 · Rev Bras Ginecol Obstet 2020; 42(08): 468-475
DOI: 10.1055/s-0040-1712994
Original Article
Surgery/Endoscopy

Preoperative Fasting Abbreviation and its Effects on Postoperative Nausea and Vomiting Incidence in Gynecological Surgery Patients

Efeitos da abreviação de jejum pré-operatório na incidência de náuseas e vômitos em pacientes cirúrgico-ginecológicas
Gisele Vissoci Marquini 
1   Department of Gynecology, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brazil
,
Francisco Edes da Silva Pinheiro 
2   Department of Gynecology, Hospital Municipal Maternidade Dr. Odelmo Leão Carneiro, Uberlândia, MG, Brazil
,
Alfredo Urbano da Costa Vieira 
2   Department of Gynecology, Hospital Municipal Maternidade Dr. Odelmo Leão Carneiro, Uberlândia, MG, Brazil
,
Rogério Melo da Costa Pinto 
3   Faculty of Mathematics, Universidade Federal de Uberlândia, Uberlândia, MG, Brazil
,
Maria Gabriela Baumgarten Kuster Uyeda 
1   Department of Gynecology, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brazil
,
Manoel João Batista Castello Girão 
1   Department of Gynecology, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brazil
,
Marair Gracio Ferreira Sartori 
1   Department of Gynecology, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brazil
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Abstract

Objective 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.

Methods 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).

Results 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.

Conclusion 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.

Resumo

Objetivo Investigar os efeitos da abreviação do jejum pré-operatório, por meio de solução enriquecida com carboidrato e proteína, na incidência de náuseas e vômitos no pós-operatório (NVPO) em cirurgias ginecológicas, população naturalmente de risco para esses episódios desagradáveis.

Métodos O presente estudo prospectivo randomizado duplo-cego foi realizado no Hospital e Maternidade Municipal Dr. Odelmo Leão Carneiro (HMMOLC), em Uberlândia, estado de Minas Gerais, Brasil, em parceria com o Departamento de Ginecologia da Universidade Federal de São Paulo (UNIFESP), aprovado pelo Comitê de Ética em Pesquisa da UNIFESP, pela diretoria do HMMOLC, registrado na Plataforma Brasil e na plataforma de Registro Brasileiro de Ensaios Clínicos. Após assinatura do termo de consentimento, foram randomizadas 80 mulheres que se submeteram à cirurgia ginecológica, de janeiro a julho de 2016, em 2 grupos: grupo controle (n = 42) e grupo suco (n = 38) que receberam, respectivamente, 200 ml de solução inerte ou 200 ml de líquido contendo carboidrato e proteína, 4 horas pré-cirurgia. Foram estudadas incidência, frequência e intensidade de NVPO por meio da Escala Visual Analógica (EVA), com análise estatística realizada pelo programa IBM SPSS Statistics for Windows, Versão 20.0 (IBM Corp, Armonk, NY, EUA).

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.

Conclusão A incidência de náuseas e vômitos foi mais baixa do que na literatura; entretanto, não se pode afirmar que foi devido à abreviação de jejum. Essa medida pode trazer maior conforto com a possibilidade de prevenção de NVPO em pacientes de risco para esses eventos.

Keywords

preoperative care - surgical procedures in gynecology - postoperative nausea and vomiting - carbohydrates - proteins - controlled random clinical trial

Palavras-chave

cuidados pré-operatórios - procedimentos cirúrgicos em ginecologia - náusea e vômito pós-operatório - carboidratos - proteínas - ensaio clínico controlado aleatório

Contributors

All of the authors were involved in the design and interpretation of the analyses, contributed to the writing of the manuscript, read and approved the final manuscript.




Publication History

Received: 06 May 2019

Accepted: 23 April 2020

Article published online:
19 June 2020

© 2020. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/).

Thieme Revinter Publicações Ltda
Rio de Janeiro, Brazil

 

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