Benefits of fasting abbreviation and early refeeding of multimodal perioperative care protocols

The multimodal protocols of perioperative care, as a European project of ERAS-Enhanced Recovery After Surgery and, in Brazil, the project ACERTO (Acceleration of Total Post-Operative Recovery), emerged as relevant alternatives to reduce preoperative discomforts, including anxiety, thirst, hunger, and enhance the recovery of surgical patients. These initiatives, supported by scientific evidence, advocate the fasting abbreviation with the ingestion of clear liquids up to 2 hours before elective surgery, as a strategy to reduce insulin resistance, immunomodulation and for the purpose of anesthetic induction, without causing risks of aspiration of gastric contents, as well as early refeeding with a small volume of diet, capable of stimulating the gastrointestinal tract and reducing the period of postoperative ileus. In this way, the literature shows that such measures are safe and bring several benefits, such as reducing hospitalization time and reducing the number of complications.