Effects of 2 - 4 hours preoperative maltodextrin 12,5% in patient with laparoscopic cholecystectomy
Main Article Content
Abstract
The purpose of fasting before anesthesia is to reduce the risk of regurgitation and aspiration. Prolonged fasting for many hours prior to surgery could lead to patient discomfort. According to the Enhance recovery after surgeryÆ Society (ERAS) and Europe Society of Anesthesia (ESA), oral pre-operative carbohydrate loading 2 hours before surgery is safe and reduce the discomfort associated with surgery. We design a randomised controlled trial, a total 40 patients with laparoscopic cholecystectomy in Hanoi Medical University Hopital. The intervention group receives maltodextrin 12.5% (200ml) 2 to 4 hours before surgery. The control group fasted from 22 hours according to the standard protocol. Discomfort scale was used to score of hunger, thirst, mouth dryness, and pain. Gastric residual volume preoperative was measured by nasogastric sonde. There was no case of lung aspiration in the intervention group. There was no difference of gastric residual volume in two groups (p = 0.1682). The average of pre-operative score discomfort was lower in the intervention group than the control group (p < 0.001). The average of post-operative score discomfort was lower in the intervention group than the control group (p > 0.05). Conclusion: pre-operative oral maltodextrin 12,5% is safe and effective on reducing patient pre-operative discomfort.
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Keywords
Key word: Matodextrin 12,5%, oral carbohydrate loading, preoperative fasting, gastric residual gastric volume, discomfort, ERAS, Maltodextrin 12,5%,, oral carbohydrate loading, preoperative fasting, gastric residual gastric volume, discomfort, ERAS
References
2. Wang ZG, Wang Q, Wang WJ et al. Randomized clinical trial to compare the effect of preoperative oral carbonhydrate versus placebo on insulin resistance after colorectal surgery. Br J Surg. 2010 mar 97 (3): 317-27.
3. Vigano J, Cereda E, Caccialanza R et al. Effect of preoperative oral carbonhydrate supplementation on postoperative metabolic stress response of patients undergoing elective abdominal surgery. World J Surg. 2012; 36(8): 1738- 43.
4. Breuer JP, Von V, Heymann C et al. Preoperative oral carbohydrate administration to ASA III–IV patients undergoing elective cardiac surgery. Anesth Analg. 2006; 103(5):1099-108.
5. Svanfeldt M, Thorell A, Hausel J et al. Randomized Clinical trial of the effect of preoperative oral carbohydrate treatment on postoperative whole-body protein and glucose kinetics. Br J Surg. 2007; 94(11):1342-50.
6. Fatos S, Avdyl K, Astrit H et al. A Randomimized trial of preoperative oral carbohydrates in abdominal Surgery. BMC Anesthesiology. 2014; 14:93.
7. Tryba M, Zenz M, Mlasowsky B et al. Does a stomach tube rnhance regurgitation during general anaesthesia? Anaesthesist 1983; 32:407-9.
8. T. Bisgaard, V.B Kristiansen. Randomized clinical trial comparing an oral carbohydrate beverage with placebo before laparoscopic cholecystectomy. Br J Surg. 2004; 91 (2): 151-8.
9. Heli H, Hanna B, Pasi O et al. Effect of pre-operative oral carbohydrate loading on recovery after day-case cholecystectomy. Eur J Anaesthesiol 2019; 36:605-611.
10. Emine O, Isil I, Omer F. The Efect of preoperative oral carbohydrate administration on insulin resistance and comfort level in patients undergoing surgery. J Perianesth Nurs. 2019; 34 (3): 539-550.
11. Nermina R, Visnja N, Senada C et al. A randomised controlled study of preoperative oral carbohydrate loading versus fasting in patients undergoing colorectal surgery. International Journal of Colorectal Disease. 2019; 34(9):1551-1561.
12. Soop M, Nygren J, Myrenfors P et al. Preoperative oral carbohydrate treatment attenuates immediate post- operative insulin resistance. Am J Physiol Endocrinol Metab. 2001; 280(4), E576-83.