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World J Gastrointest Surg. Mar 27, 2010; 2(3): 57-60
Published online Mar 27, 2010. doi: 10.4240/wjgs.v2.i3.57
Reducing preoperative fasting time: A trend based on evidence
José Eduardo de Aguilar-Nascimento, Diana Borges Dock-Nascimento
José Eduardo de Aguilar-Nascimento, Department of Surgery, University of Mato Grosso, Cuiabá 78000-000, Brazil
Diana Borges Dock-Nascimento, Nutrition School, Multiprofessional Nutrition Team, Julio Muller Hospital, University of Mato Grosso, Cuiabá 78000-000, Brazil
Author contributions: Both authors made substantial contributions to the conception, design and drafting of the article and agree with the final version.
Correspondence to: José Eduardo de Aguilar-Nascimento, MD, PhD, Professor, Department of Surgery, University of Mato Grosso, Cuiabá 78000-000, Brazil. aguilar@terra.com.br
Telephone: +55-65-36237183 Fax +55-65-36234020
Received: November 3, 2009
Revised: January 12, 2010
Accepted: January 19, 2010
Published online: March 27, 2010

Preoperative fasting is mandatory before anesthesia to reduce the risk of aspiration. However, the prescribed 6-8 h of fasting is usually prolonged to 12-16 h for various reasons. Prolonged fasting triggers a metabolic response that precipitates gluconeogenesis and increases the organic response to trauma. Various randomized trials and meta-analyses have consistently shown that is safe to reduce the preoperative fasting time with a carbohydrate-rich drink up to 2 h before surgery. Benefits related to this shorter preoperative fasting include the reduction of postoperative gastrointestinal discomfort and insulin resistance. New formulas containing amino acids such as glutamine and other peptides are being studied and are promising candidates to be used to reduce preoperative fasting time.

Keywords: Perioperative care, Anesthesia complications, Preoperative fasting, Insulin resistance, Carbohydrate, Nutrition