Efeitos da abreviação do jejum pré-operatório com solução de carboidrato e proteína na resposta metabólica e sintomas pós-operatórios em cirurgias ginecológicas. Estudo controlado randomizado duplo-cego
Data
2018-03-29
Autores
Vissoci, Gisele 
Orientadores
Sartori, Marair Gracio Ferreira
Tipo
Tese de doutorado
Título da Revista
ISSN da Revista
Título de Volume
Resumo
Objetivos. Investigar os efeitos da abreviação do jejum pré-operatório sobre a resposta orgânica ao trauma e a resistência periférica à insulina por meio da ingestão de fórmula líquida contendo carboidrato e proteína, em pacientes que se submeteram a cirurgias ginecológicas.Métodos. O estudo, prospectivo randomizado duplo-cego, foi realizado no Hospital e Maternidade Municipal Dr. Odelmo Leão Carneiro (HMMOLC),hospital de média complexidade em Uberlândia – MG, em parceria com o Departamento de Ginecologia da Universidade Federal de São Paulo (UNIFESP), após aprovação do Comitê de Ética em Pesquisa da UNIFESP e diretoria do HMMOLC. Após assinatura do temo de consentimento, foram randomizadas80 mulheres que se submeteram à cirurgia ginecológica, no período de janeiro a julho de 2016,em dois grupos: grupo controle (N=42) e grupo suco (N=38) recebendo, respectivamente, 200 ml de solução inerte ou líquido contendo carboidrato e proteína, 4 horas pré-cirurgia. As variáveis estudadas foram: glicemia, insulina, resistência insulínica (HOMA-IR), proteína-C-reativa e albumina, com análise estatística realizada pelo programa SPSS 20.0.Resultados.Os Coeficientes de Variação (CV) da glicemia, insulina, albumina e índice de HOMAentrepréepósoperatório, do grupo suco, foram menos significativos que do grupo controle. Houve diferençamenor que a metade no CV para o índice de HOMA no gruposuco, de 8,46% (p=0,03), em relação à solução inerte, que foi de 17,27% (p=0,001). Conclusões.A ingestão de líquido contendo carboidrato e proteína até 4 horas antes de cirurgias ginecológicas favorece maior estabilidade metabólica, com menor variação na resistência insulínica, que a ingestão de solução inerte. A prática pode ser encorajada com a finalidade de oferecer maior qualidade de recuperação pós-operatória.
Objective. To investigate the effects of the preoperative fasting abbreviation on the organic response to trauma, peripheral resistance to insulin through the ingestion of liquid containing carbohydrate and protein in patients who underwent gynecological surgeries. Methods. The prospective, double-blind, randomized study was performed at Hospital and Maternity Dr. OdelmoLeãoCarneiro (HMMOLC), a mediumcomplexity hospital in Uberlândia, Brazil, in partnership with the Department of Gynecology of Federal University of São Paulo (UNIFESP), after approval of the Research Ethics Committee of UNIFESP and board of HMMOLC. After the signing of the consent form, 80 women, who were submitted to gynecological surgery in the period from January to July (2016), were randomized in two groups: the control group (42) or the juice group (38). They received respectively 200 ml of inert solution or liquid containing carbohydrate and protein 4 hours pre-surgery. The variables studied were: glycemia, insulin, insulin resistance index (HOMA), C-reactive protein and albumin with statistical analysis performed by the SPSS 20.0 program. Results.The coefficients of variation (CV) of glycemia, insulin, albumin and HOMA index between pre and postoperative of the juice group were less significant than in the control group. There was a difference of less than half in the CV for the HOMA index in the juice group, of 8.46% (p = 0.03), in relation to the inert solution, which was 17.27% (p = .001).Conclusions.The ingestion of carbohydrate and protein containing fluid up to 4 hours before gynecological surgeries favors greater metabolic stability, with lower variation in insulin resistance, than ingestion of inert solution.The practice can be encouraged for the purpose of offering higher quality of postoperative recovery.
Objective. To investigate the effects of the preoperative fasting abbreviation on the organic response to trauma, peripheral resistance to insulin through the ingestion of liquid containing carbohydrate and protein in patients who underwent gynecological surgeries. Methods. The prospective, double-blind, randomized study was performed at Hospital and Maternity Dr. OdelmoLeãoCarneiro (HMMOLC), a mediumcomplexity hospital in Uberlândia, Brazil, in partnership with the Department of Gynecology of Federal University of São Paulo (UNIFESP), after approval of the Research Ethics Committee of UNIFESP and board of HMMOLC. After the signing of the consent form, 80 women, who were submitted to gynecological surgery in the period from January to July (2016), were randomized in two groups: the control group (42) or the juice group (38). They received respectively 200 ml of inert solution or liquid containing carbohydrate and protein 4 hours pre-surgery. The variables studied were: glycemia, insulin, insulin resistance index (HOMA), C-reactive protein and albumin with statistical analysis performed by the SPSS 20.0 program. Results.The coefficients of variation (CV) of glycemia, insulin, albumin and HOMA index between pre and postoperative of the juice group were less significant than in the control group. There was a difference of less than half in the CV for the HOMA index in the juice group, of 8.46% (p = 0.03), in relation to the inert solution, which was 17.27% (p = .001).Conclusions.The ingestion of carbohydrate and protein containing fluid up to 4 hours before gynecological surgeries favors greater metabolic stability, with lower variation in insulin resistance, than ingestion of inert solution.The practice can be encouraged for the purpose of offering higher quality of postoperative recovery.
Descrição
Citação
MARQUINI, Gisele Vissoci. Efeitos da abreviação do jejum pré-operatório com solução de carboidrato e proteína na resposta metabólica e sintomas pós-operatórios em cirurgias ginecológicas : estudo controlado randomizado duplo-cego. 2018. 90 f. Tese (Doutorado em Medicina: ginecologia) - Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, 2018