Department of Anesthesiology and ICU, University Hospital Rijeka, Rijeka, Croatia.
Wien Klin Wochenschr. 2010 Jan;122(1-2):50-3. doi: 10.1007/s00508-009-1301-9.
Preoperative fasting is associated with various untoward postoperative health problems. Previous studies have stressed the advantages of preoperative feeding with a carbohydrate-rich drink 2 hours before surgery; this protocol does not increase the risk of gastric-content aspiration but reduces the level of anxiety and thirstiness during the perioperative period. Spinal anesthesia with the local anesthetic bupivacaine can decrease gastric emptying in the early postoperative period. However, the effect of spinal anesthesia on the gastric emptying rate following preoperative feeding is unknown. The aim of this study was to determine the impact of preoperative feeding with a clear carbohydrate-rich drink on gastric emptying early after orthopedic surgery under spinal anesthesia.
A total of 110 patients scheduled for semi-elective orthopedic surgery under spinal anesthesia were included in a randomized controlled trial. Patients were randomly assigned to two groups: group 1 (56 patients) received a standardized 200 ml of clear carbohydrate-enriched drink orally 2 hours before surgery; group 2 (54 patients) acted as a control group with no preoperative feeding. Gastric emptying was evaluated with a paracetamol test at five time points: 15 min, 30 min, 60 min, 90 min and 120 min after administration of paracetamol.
No significant differences were observed between the two groups in paracetamol plasma concentrations or area under the curve during the early postoperative period.
In patients undergoing spinal anesthesia, preoperative feeding 2 hours before surgery had no influence on the gastric emptying rate, indicating that preoperative feeding does not increase the risk of gastric-content aspiration and can be given safely.
术前禁食与各种不良术后健康问题有关。先前的研究强调了在手术前 2 小时给予富含碳水化合物的饮料进行术前喂养的优势；该方案不会增加胃内容物吸入的风险，但会降低围手术期的焦虑和口渴感。局部麻醉布比卡因的脊髓麻醉可减少术后早期的胃排空。然而，脊髓麻醉对术前喂养后胃排空率的影响尚不清楚。本研究旨在确定在脊髓麻醉下进行择期骨科手术后，术前给予富含清晰碳水化合物的饮料对胃排空的早期影响。
共有 110 名计划在脊髓麻醉下进行半择期骨科手术的患者被纳入一项随机对照试验。患者被随机分为两组：组 1（56 例）在手术前 2 小时口服 200 毫升标准化清晰碳水化合物丰富的饮料；组 2（54 例）为对照组，无术前喂养。通过对乙酰氨基酚试验在五个时间点评估胃排空：给予对乙酰氨基酚后 15 分钟、30 分钟、60 分钟、90 分钟和 120 分钟。
两组患者术后早期的对乙酰氨基酚血浆浓度或曲线下面积均无显著差异。
在接受脊髓麻醉的患者中，手术前 2 小时的术前喂养对胃排空率没有影响，这表明术前喂养不会增加胃内容物吸入的风险，可以安全进行。
