title: Safety of oral glutamine in the abbreviation of preoperative fasting: a double-blind, controlled, randomized clinical trial.
abstract: BACKGROUND
  No study so far has tested a beverage containing glutamine 2 h before anesthesia in patients undergoing surgery.
  
  
  OBJECTIVE
  The aim of the study was to investigate: 1) the safety of the abbreviation of preoperative fasting to 2 h with a carbohydrate-L-glutamine-rich drink; and 2) the residual gastric volume (RGV) measured after the induction of anesthesia for laparoscopic cholecystectomies.
  
  
  METHODS
  Randomized controlled trial with 56 women (42 (17-65) years-old) submitted to elective laparoscopic cholecystectomy. Patients were randomized to receive either conventional preoperative fasting of 8 hours (fasted group, n = 12) or one of three different beverages drunk in the evening before surgery (400 mL) and 2 hours before the initiation of anesthesia (200 mL). The beverages were water (placebo group, n = 12), 12.5% (240 mOsm/L) maltodextrine (carbohydrate group, n = 12) or the latter in addition to 50 g (40 g in the evening drink and 10 g in the morning drink) of L-glutamine (glutamine group, n = 14). A 20 F nasogastric tube was inserted immediately after the induction of general anesthesia to aspirate and measure the RGV.
  
  
  RESULTS
  Fifty patients completed the study. None of the patients had either regurgitation during the induction of anesthesia or postoperative complications. The median (range) of RGV was 6 (0-80) mL. The RGV was similar (p = 0.29) between glutamine group (4.5 [0-15] mL), carbohydrate group (7.0 [0-80] mL), placebo group (8.5 [0-50] mL), and fasted group (5.0 [0-50] mL).
  
  
  CONCLUSIONS
  The abbreviation of preoperative fasting to 2 h with carbohydrate and L-glutamine is safe and does not increase the RGV during induction of anesthesia.
authors.affiliation: Department of Food and Nutrition, Federal University of Mato Grosso, Cuiabá, Brazil.
authors.forename: D
authors.initials: D
authors.lastname: Borges Dock-Nascimento
authors.forename: J E D
authors.initials: JE
authors.lastname: Aguilar-Nascimento
authors.forename: C
authors.initials: C
authors.lastname: Caporossi
authors.forename: M
authors.initials: M
authors.lastname: Sepulveda Magalhães Faria
authors.forename: R
authors.initials: R
authors.lastname: Bragagnolo
authors.forename: F Stephan
authors.initials: FS
authors.lastname: Caporossi
authors.forename: D
authors.initials: D
authors.lastname: Linetzky Waitzberg
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000758:Anesthesia; D017081:Cholecystectomy, Laparoscopic; D004040:Dietary Carbohydrates / Q000627:therapeutic use; D004311:Double-Blind Method; D005215:Fasting / Q000502:physiology*; D005260:Female; D005973:Glutamine / Q000009:adverse effects* / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008875:Middle Aged; D057234:Preoperative Period; D018401:Sample Size; D013270:Stomach / Q000033:anatomy & histology; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D004040:Dietary Carbohydrates; D005973:Glutamine