when they put patients under
sedation or use a general anes-
thetic," says Bryan Collier, DO,
FACS, a professor of surgery
and director of surgical nutrition
at the Virginia Tech Carilion
School of Medicine in Roanoke,
Va. "However, the literature
shows drinking glucose and
water 2 hours before anesthesia
empties from the stomachs of
patients without gastric empty-
ing issues."
Healthy eating habits
Efforts to improve patients' nutritional status before surgery should
also include screening for malnutrition, regardless of a patient's out-
ward appearance — an obese individual isn't necessarily well nour-
ished, points out Dr. Nelson. Detailed screening tools are available,
but he says 2 basic questions can be used to quickly identify patients
who might need further assessment:
• Have you lost weight in the past 6 months without trying to lose
this weight?
• Have you been eating less than usual for more than a week?
Patients who screen positive for malnourishment should receive
counseling from a dietician or nutritionist before having surgery.
Putting patients on a healthy diet and prescribing a prehab exercise
routine — one is ineffective without the other — for 4 to 6 weeks lead-
ing up to their procedures helps to build lean body mass and reduces
the body's inflammatory response to surgery.
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 3
Patients are still asked
to comply with a directive
that's based on assumptions
instead of solid evidence.
