anesthetics inflict some degree of trauma or distress on the patient's
body. On some level, great or small, surgery's a shock to the system.
Rejecting the time-honored "fast after midnight" approach, a grow-
ing number of doctors, industry organizations and experts believe that
more rigorous and thoughtful pre-op nutrition — lasting from weeks
before to just 2 hours before surgery — can help bodies not only
accommodate the stresses of surgery, but heal faster, too. Here's a
look at the latest science behind pre-op nutrition, as well as a
roundup of beverages (see "A Bounty of Pre-op Nutrition Drinks" on
p. 30).
Peak patient prep
David Evans, MD, is not only the medical director of trauma services at
The Ohio State University Wexner Medical Center, but he's also its med-
ical director of nutrition services, and a widely cited expert on surgical
nutrition. The co-author of a December 2013 paper, "Nutrition
Optimization Prior to Surgery" (osmag.net/bQ6VYp), published in the
American Society for Parenteral and Enteral Nutrition's (ASPEN) jour-
nal Nutrition in Critical Practice, he's representative of the evolving
views on this subject. The first sentence of that paper's abstract captures
his overall perspective: "Optimization of metabolic state prior to major
surgery leads to improved surgical outcomes."
"You want to make sure that the immune system is well-fed, well-
nourished and robust and able to heal the wound and fight off any
potential infection," Dr. Evans tells Outpatient Surgery. To do that,
your patient's nutrition levels should be at or near their peak.
Especially needed are protein stores, the amino acids that build them,
and the vitamins and minerals — like Vitamins C and B12 and zinc —
that serve as cofactors and as the fuel for cells to heal, he says.
But how do you know how much pre-op nutrition a specific patient
M A R C H 2 0 1 9 • O U T PA T I E N T S U R G E R Y. N E T • 4 5
