Dr. Wahr would like
to add pre-surgery
drinks to her health
system's pre-op proto-
cols, but finds it hard
to justify adding $24
(the drinks cost about
$12 a piece and
patients should down
2 before surgery, she
says) to case costs.
Instead, for now, they
tell patients to drink
apple juice. Black cof-
fee is OK, too. Dr.
Wahr points out that
patients can head to a
health food store to
get maltodextrin
pouches that marathon runners use to carbo-load before races.
Roschelle Heuberger, PhD, RD, a professor of dietetics and nutrition at
Central Michigan University in Mt. Pleasant, Mich., says adding carbohy-
drates to the bloodstream before surgery stimulates the body's cells,
including those that are responsible for decreasing inflammation and tis-
sue repair.
"The body needs nutrients to recover from surgery and if it doesn't
have sufficient calories, it ends up cannibalizing its own muscle," says
Dr. Heuberger. "That releases inflammatory cytokines, which disrupt
glucose metabolism. It becomes a harmful cascade."
5 6 • O U T PA T I E N T S U R G E R Y M A G A Z I N E • O C T O B E R 2 0 1 8
• AVOIDABLE HARM NPO adds to patient discomfort, can slow recoveries and
increases the risk of post-operative nausea and vomiting.
Pamela
Bevelhymer,
RN,
BSN,
CNOR
