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Previous issue date: 2016-08-29 / O jejum pr?-operat?rio foi institu?do h? muitos anos, no in?cio das pr?ticas anest?sicas, para garantir o esvaziamento do conte?do g?strico, evitar bronco-aspira??o, v?mitos, regurgita??o, administra??o de v?rias drogas para reduzir a acidez g?strica e volume. Protocolos de jejum pr?-operat?rio sugerem per?odos menores de jejum, principalmente para l?quidos, permitindo mais conforto aos pacientes, e menor risco de hipoglicemia e desidrata??o, sem aumentar a incid?ncia de aspira??o pulmonar perioperat?ria. O objetivo do estudo foi avaliar se o bioproduto ? base de ?gua de coco e maltodextrina (ACP Surgery) supria as necessidades dos protocolos cl?nicos de jejum pr?-operat?rio de curta dura??o do projeto ACERTO (Acelera??o da Recupera??o Total P?s-operat?ria) com boa toler?ncia e aceita??o. Foi realizado um estudo prospectivo, aleat?rio, controlado e duplo cego em seres humanos, em um grupo de 49 pacientes na Santa Casa de Miseric?rdia de Fortaleza, para comprovar a efici?ncia e efic?cia do ACP Surgery para atingir as metas e efeitos planejados nos protocolos de jejum pr?-operat?rio de curta dura??o. Os grupos experimentais foram: G1 [grupo controle; Nutri Dextrin (Nutrimed, Fortaleza, Cear?); n = 20) e G2 [interven??o; ACP Surgery (ACP Biotecnologia, Fortaleza, Cear?; n = 29]. No intervalo entre 10 e 20 horas da realiza??o da cirurgia, amostra de sangue era colhida de cada paciente e encaminhada para o Laborat?rio de An?lises Cl?nicas do hospital para mensura??o dos n?veis s?ricos de leuc?citos totais, glicose, s?dio, pot?ssio e cloro. Os dados foram submetidos ao teste t (? = 95%, p > 0,05 e ?rea de rejei??o t > 1,96) e expressos em m?dia e desvio padr?o. Os grupos G1 (Nutri Dextrin) e G2 (ACP Surgery) apresentaram os seguintes resultados quanto ?s an?lises sangu?neas: leuc?citos totais G1 = 11.322,64 + 5.033,94, e G2 = 11.074,14 + 4.480,35; s?dio G1 = 140,8 + 4,14 mEq/l, e G2 = 139,3 + 4,38 mEq/l; pot?ssio G1 = 4,16 + 0,65 mEq/l, e G2 = 4,18 + 0,47 mEq/l; cloro G1 = 107,4 + 4,69 mEq/l, e G2 = 107,1 + 6,88 mEq/l; e glicose G1 =130,3 + 39,96 mg/dl, e G2 = 123,9 + 36,47 mg/dl. Em todas as vari?veis estudadas o p > 0,05, portanto, pode-se considerar que os produtos Nutri Dextrin e ACP Surgery s?o equivalentes. A aceita??o do ACP Surgery foi de 97%, sem relatos de pigarro ou n?useas (toler?ncia de 100%), sem perda de palatabilidade. Conclui-se que o bioproduto produzido supriu as necessidades e especifica??es dos protocolos de jejum pr?-operat?rio de curta dura??o apresentando aceita??o e toler?ncia compat?vel com o produto comercial ao mesmo tempo em que reduziu os custos e facilitou a execu??o do protocolo. / The preoperative fasting was instituted many years ago, at the beginning of the anesthetic practice, to ensure the emptying of the stomach contents, avoid bronchial aspiration, vomiting, regurgitation, administration of various drugs to reduce gastric acidity and volume. Preoperative fasting protocols suggest shorter fasting periods especially for liquids, providing more comfort to the patient, and less risk of hypoglycemia and dehydration, without increasing the incidence of perioperative pulmonary aspiration. The aim of the study was to assess whether the bioproduct based on coconut water and maltodextrin (ACP Surgery) supplied the needs of clinical trials of ERAS project (Enhanced Recovery After Surgery) with good tolerance and acceptance. It was conducted a prospective, randomized, controlled, double-blind study in humans with a group of 49 patients at the Santa Casa de Misericordia de Fortaleza, to prove the efficiency and effectiveness of ACP Surgery to achieve the goals and planned effects on ERAS project. The experimental groups were: G1 [control group; Nutri Dextrin (Nutrimed, Fortaleza, Cear?); n = 20) and G2 [intervention; ACP Surgery (ACP Biotecnologia, Fortaleza, Cear?;. N = 29]. In the interval between 10 and 20 hours prior to the surgery, blood sample was taken from each patient and sent to the Hospital's Laboratory of Clinics Analysis for measurement of serum levels of total leukocytes, glucose, sodium, potassium and chlorine. The data were submitted to t test (? = 95%, p> 0.05 and t rejection area > 1.96) and expressed as mean and standard deviation. The G1 (Nutri Dextrin) and G2 (ACP Surgery) showed the following results regarding blood tests: total leukocyte G1 = 11,322.64 + 5,033.94, and G2 = 11,074.14 + 4,480.35; sodium G1 = 140.8 + 4.14 mEq/L, and G2 = 139.3 + 4.38 mEq/L; potassium G1 = 4.16 + 0.65 mEq/L, and G2 = 4.18 + 0.47 mEq/L; chloro G1 = 107.4 + 4.69 mEq/L, and G2 = 107.1 + 6.88 mEq/L; and glucose G1 = 130.3 + 39.96 mg/dL, and G2 = 123.9 + 36.47 mg/dL. In all variables p> 0.05, so it can be considered that Nutri Dextrin and ACP Surgery products are equivalent. The acceptance of the ACP Surgery was 97%, with no reports of cough or nausea (100% tolerance), without loss of palatability. It follows that the produced bioproduct met the needs and specifications of preoperative fasting protocols of short duration, showing acceptance and tolerance compatible with the commercial product at the same time reducing costs and facilitating protocol implement.
| Identifer | oai:union.ndltd.org:IBICT/oai:repositorio.ufrn.br:123456789/23519 |
| Date | 29 August 2016 |
| Creators | Costa, Henrique Jorge Maia |
| Contributors | 69245975304, http://lattes.cnpq.br/6977355824972138, Marques, Djalma Nunes, 09588825415, http://lattes.cnpq.br/2728267888208765, Nascimento, Jos? Eduardo Aguilar Siqueira do, 14219603115, http://lattes.cnpq.br/0439577158192249, Nunes, Jos? Ferreira, 03121950363, http://lattes.cnpq.br/2976613011582984, Moreira, Renato de Azevedo, 00114715300, http://lattes.cnpq.br/4451208231291916, Salgueiro, Cristiane Clemente de Mello |
| Publisher | PROGRAMA DE P?S-GRADUA??O EM BIOTECNOLOGIA, UFRN, Brasil |
| Source Sets | IBICT Brazilian ETDs |
| Language | Portuguese |
| Detected Language | English |
| Type | info:eu-repo/semantics/publishedVersion, info:eu-repo/semantics/doctoralThesis |
| Source | reponame:Repositório Institucional da UFRN, instname:Universidade Federal do Rio Grande do Norte, instacron:UFRN |
| Rights | info:eu-repo/semantics/openAccess |
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