Abreviação do jejum pré-operatório em pacientes com obesidade: uma revisão narrativa

Abstract

The practice of conventional fasting (8 - 12 hours) was implemented a long time ago with the aim of promoting gastric emptying and avoiding complications during anesthetic induction. However, this strategy has negative effects such as increased discomfort, thirst, hunger, in addition to increased metabolic stress from the trauma. In this sense, the abbreviation of preoperative fasting is becoming widespread, as studies show that it promotes an improvement in the metabolic response to trauma, reduces discomfort and length of hospital stay and does not pose greater risks of aspiration and regurgitation. Therefore, the objective is to review the literature on the efficacy/safety of shortening preoperative fasting in patients with obesity. To select the studies, the Google Scholar, SCIELO, VHL, LILACS and PUBMED tools/databases were used, using the following descriptors: “obesity”, preoperative fasting”, “surgery”, in Portuguese and English. The studies were chosen primarily by eading the title and abstract and then by reading the complete article in its entirety. Several benefits were elucidated for post-surgical patients, such as greater comfort and well-being, accelerated recovery, reduced hospital stay and symptoms such as thirst, hunger, pain and agitation, improved glycemic profile and reduced post-surgical morbidity. Although the obese population is still rarely mentioned in studies, research carried out with obese people in their sample revealed benefits similar to those shown for the non-obese population. However, these studies are still scarce, and more studies are needed, including obese patients, to reinforce the effectiveness and advantages of the protocol for this group.