[Evaluation of changes made in the peri-operative care in patients submitted to elective abdominal surgery].
OBJECTIVE
To evaluate the results of the introduction of new measures to accelerate the postoperative recovery of patients undergoing elective abdominal surgery.


METHODS
We observed 162 patients and interviewed them on two distinct periods: the first between October to December 2009 (n = 81) comprised patients who underwent conventional perioperative monitoring (pre-intervention) and the second between March and May 2010 (n = 81), formed by a new group of patients, submitted to the new protocol of perioperative monitoring. Data collection in the two periods occurred without the knowledge of the professionals in the service. The variables were: indication for preoperative nutritional support, duration of fasting, post-operative volume of hydration, use of catheters and drains, length of stay and postoperative morbidity.


RESULTS
when comparing the two periods we observed a decrease of 2.5 hours in the time of preoperative fasting (p = 0.0002) in the post-intervention group. As for the reintroduction of oral diet, there was no difference between the two periods (p = 0.0007). When considering the patients without postoperative complications, there was a significantly decreased length of stay (p = 0.001325). There was a reduction of approximately 50% in antibiotic use in the post-intervention group (p = 0.00001).


CONCLUSIONS
The adoption of multidisciplinary perioperative measures is feasible within our reality, and although there was no statistically significant changes in the present study, it may improve morbidity and reduce length of stay in general surgery.
Departamento de Clínica Cirúrgica, Universidade do Sul de Santa Catarina, SC, Brazil. mayrarmartins@hotmail.com
Mayra da Rosa Martins
Mda R
Walczewski
Ariane Zanetta
AZ
Justino
Eduardo André Bracci
EA
Walczewski
Tatiane
T
Coan
D000005:Abdomen / Q000601:surgery*; D017558:Elective Surgical Procedures / Q000592:standards*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019990:Perioperative Care / Q000379:methods*; D011446:Prospective Studies