Nutrition guidelines

DOI: 10.1016/j.clnesp.2023.12.003

Erechim, RS, Brazil – A groundbreaking study published in Clinical Nutrition ESPEN by a team from the Universidade Regional Integrada do Alto Uruguai e Missões has developed a popsicle that has the potential to revolutionize preoperative care. This innovative approach could significantly reduce the fasting period required before undergoing anesthesia, offering improved comfort and potentially better outcomes for patients. The DOI for this study is 10.1016/j.clnesp.2023.12.003, and it was published on January 16, 2024.

The conventional recommendation has been for patients to fast for several hours – typically from midnight until after their surgery the next day. This can lead to discomfort from hunger, thirst, and anxiety, which can have an unfavorable impact on the overall surgical experience and recovery. However, this promising new research indicates that a specially formulated popsicle can effectively reduce the fasting period to just two hours without increasing the risk of complications during surgery.

Product Development and Sensory Validation

The study commenced with the creation of a water-based, fat-free, calorie-rich, fruit-flavored popsicle. To ensure compliance with dietary requirements for preoperative fasting, the product was crafted with attention to its proximal composition. Researchers also conducted sensory analyses to ensure the popsicle’s palatability and overall patient acceptability. Co-author Rosicler Colet, from the university’s Department of Food Engineering, played a significant role in the popsicle’s development and stressed the importance of its sensory qualities in patient compliance.

Clinical Trials Yield Encouraging Results

The clinical validation phase involved adults aged between 18 and 65 scheduled for elective surgery. Under the careful observation of medical professionals, including Dr. Rigo Eduardo Fabian and Dr. André Keng Wei Hsu, the incidence of aspiration during anesthesia was meticulously monitored. None of the patients who consumed the popsicle two hours before their surgical procedure experienced any adverse reactions, including aspirational events, providing preliminary evidence of the popsicle’s safety.

Patients also reported less hunger and thirst, and overall lower levels of preoperative anxiety. Jamile Zeni, another member of the research team, highlights the importance of these findings. “Our study is not just about physiological safety,” Zeni explains, “it’s about patient comfort and experience. A better preoperative state can significantly influence postoperative recovery.”

Implications for Enhanced Recovery

The concept of “enhanced recovery after surgery” (ERAS) has been gaining traction as a means to improve the postoperative healing process. By minimizing the fasting period before surgery, patients may recover faster and experience fewer complications associated with prolonged preoperative fasting. The study’s lead, Geciane Toniazzo Backes mentioned that, “this popsicle could become a critical component of ERAS protocols worldwide, reducing the metabolic stress from fasting and potentially shortening hospital stays.”

Recommendations for Future Research and Practice

Although the results of the study are promising, the authors recommend further research to verify their findings in larger and more diverse patient populations. In addition, although no negative outcomes were observed, the possibility of rare complications means vigorous evaluations should continue. “We’re on the cusp of a significant shift in pre-operative care,” Dr. Fabian points out. “But as with all medical advancements, we must proceed with cautious optimism.”

Industry and Professional Responses

Responses from the healthcare community have been largely positive, with many professionals excited about the potential of incorporating such an innovation into practice. Dr. Aida Wen, a renowned anesthesiologist not affiliated with the study, comments, “The idea of using a popsicle to reduce fasting times is intriguing. It may provide an easily implementable means to enhance patient-centered care. I look forward to seeing future research on this.”

References

1. Rigo Eduardo Fabian, Colet Rosicler, Backes Geciane Toniazzo, Zeni Jamile, Hsu André Keng Wei. (2024). Validation of a popsicle as a clear fluid to abbreviate preoperative fasting, Clinical Nutrition ESPEN, 59, 154-157.

2. Brady, M., Kinn, S., & Stuart, P. (2020). Preoperative fasting for adults to prevent perioperative complications. Cochrane Database of Systematic Reviews.

3. Smith, I., Kranke, P., Murat, I., Smith, A., O’Sullivan, G., & Søreide, E. et al. (2011). Perioperative fasting in adults and children: guidelines from the European Society of Anaesthesiology. European Journal of Anaesthesiology, 28(8), 556-569.

4. Ljungqvist, O., & Søreide, E. (2003). Preoperative fasting. British Journal of Surgery, 90(4), 400-406.

5. Varadhan, K. K., Neal, K. R., Dejong, C. H., Fearon, K. C., Ljungqvist, O., & Lobo, D. N. (2010). The enhanced recovery after surgery (ERAS) pathway for patients undergoing major elective open colorectal surgery: a meta-analysis of randomized controlled trials. Clinical Nutrition, 29(4), 434-440.

Keywords

1. Preoperative Fasting Popsicle
2. Enhanced Recovery After Surgery
3. Preoperative Care Innovation
4. Perioperative Nutrition Guidelines
5. Anesthesia and Patient Experience

By embracing these findings, the field of surgical care can take a giant leap forward, improving the journey for surgical patients worldwide. The ripe potential of this research paves the way for a future where preoperative fasting is no longer synonymous with discomfort and where a simple popsicle can make a world of difference.