"Pre-op fasting is a
concept that's been
ingrained in surgeons
and anesthesiologists
since medical school,"
says Gregg Nelson,
MD, PhD, FRCSC, a
professor at the Tom
Baker Cancer Centre
in Calgary, Alberta,
Canada. "But in reali-
ty, the practice isn't supported by evidence. In fact, evidence shows it
may result in patient harm."
A fasting state — when food has been completely digested and
stored — occurs as soon as 4 hours after eating and can lead to post-
op insulin resistance, hyperglycemia and dehydration. On the other
hand, patients who carbohydrate load by drinking 50 g of maltodex-
trin reconstituted in a clear liquid or pre-surgery complex-carbohy-
drate drinks up to 2 hours before surgery are more physically pre-
pared to endure the rigors of surgery.
Their blood glucose and blood pressure levels are stable, and they're
less likely to experience insulin resistance from the stress of surgery.
They'll also be in less pain and at lower risk of suffering post-op infec-
tions — factors that impact patient satisfaction and lead to better out-
comes. You also can't ignore the importance of improving the patient
experience. Patients who consume a formulated drink before arriving
for surgery feel fuller and hydrated, and therefore more comfortable
and potentially less anxious.
It's important to know which type of fluids patients should consume
in the hours leading up to surgery. "Many surgical professionals
D E C E M B E R 2 0 1 9 • O U T PA T I E N T S U R G E R Y. N E T • 6 1
• PARTNERS IN CARE Efforts to improve outcomes after surgery have led to
patients and providers becoming more aware of the importance of pre-op nutrition.
