• Gisele Vissoci Marquini, Francisco Edes da Silva Pinheiro, Alfredo Urbano da Costa Vieira, Rogério Melo da Costa Pinto, Maria Gabriela Baumgarten Kuster Uyeda, GirãoManoel João Batista CastelloMJBCDepartment of Gynecology, Federal University of São Paulo, São Paulo, Brazil., and SartoriMarair Gracio FerreiraMGFDepartment of Gynecology, Federal University of São Paulo, São Paulo, Brazil..
• Department of Gynecology, Federal University of São Paulo, São Paulo, Brazil. Electronic address: giselemarquini@gmail.com.
• Nutrition. 2020 Sep 1; 77: 110790.

ObjectivesRecommended perioperative nutritional interventions may contribute to satisfactory surgical outcomes. Each moment in the course of a surgical pathologic condition may be a window of opportunity for an intervention with a positive impact on postoperative recovery. Based on the idea of accelerating postoperative recovery, the objective of this study was to evaluate the effectiveness of a nutritional intervention with preoperative fasting abbreviation (Enhanced Recovery After Surgery recommendations) on the metabolism of patients undergoing gynecologic surgeries under spinal anesthesia.MethodsThis randomized clinical trial was performed at a hospital of medium complexity. After Human Research Ethics Committee approval on August 24, 2015, 80 women who had gynecologic surgery in the period from January to June 2016 and signed the consent form were randomly allocated into two groups: a control group (n = 42) and a juice group (n = 38). They received 200 mL of inert solution (control group) or liquid enriched with carbohydrate and protein (juice group) 4 h before surgery. The variables studied were serum glucose, insulin, insulin resistance evaluated by the homeostatic model assessment of insulin resistance (HOMA-IR), C-reactive protein, and albumin in the pre- and postoperative periods. The statistical analysis was performed with SPSS 20.0.ResultsThere was a statistically significant difference in the coefficient of variation for the HOMA-IR index in the control group (17.27%; P < 0.01) compared with the juice group (8.46%; P < 0.05), which remained stable from the pre- to the postoperative period.ConclusionsPreoperative fasting abbreviation with liquid containing carbohydrate and protein before gynecologic surgeries may provide metabolic stability with lower variation in insulin resistance than inert solution.Copyright © 2020 Elsevier Inc. All rights reserved.

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