Tanno Masaru, Fukushima Hisashi, Tanaka Yoshiaki, Ohara Sayaka
Department of Anesthesiology, NHO Mito Medical Center, Ibaraki 311-3193.
Masui. 2013 Aug;62(8):910-5.
Enhanced Recovery After Surgery (ERAS) program recommends carbohydrate load before surgery. However, the dose and dosing method of carbohydrate load are not clear. In this paper, effect of different preoperative rehydration on sugar metabolism in healthy volunteers is reported.
Arginaid Water (ArgW) and OS-1 (OS) used as preoperative rehydration in Japan were employed for measuring sequential changes in sugar metabolism in blood. Both ArgW intake group and OS intake group started fasting at 9 PM. At 8 AM in the morning, respective preoperative rehydration 250 ml was taken as a bolus. Blood test was performed before intake, 30 minutes, 2 hours and 4 hours after intake.
Subject included 10 healthy volunteers for ArgW and OS respectively. Subjects drank each preoperative rehydration two hours before entering operating room. In ArgW intake group, free fatty acid (FFA) and beta-hydroxybutyric acid concentration (beta-OHB) were reduced and sugar metabolism was favorably maintained. Meanwhile, OS intake group, FFA and beta-OHB were elevated and catabolism of adipose began. However, even if ArgW were taken, rebound increases of FFA and beta-OHB were observed after entering operating room.
Optimum dosage and dosing method of preoperative carbohydrate should be scientifically verified in the future.
术后加速康复(ERAS)方案推荐术前进行碳水化合物负荷。然而,碳水化合物负荷的剂量和给药方法尚不清楚。本文报道了不同术前补液对健康志愿者糖代谢的影响。
采用日本用作术前补液的精氨酸水(ArgW)和OS-1(OS)来测量血液中糖代谢的连续变化。ArgW摄入组和OS摄入组均于晚上9点开始禁食。次日上午8点,分别快速静脉推注250ml各自的术前补液。在摄入前、摄入后30分钟、2小时和4小时进行血液检测。
ArgW组和OS组各纳入10名健康志愿者。受试者在进入手术室前两小时饮用各自的术前补液。在ArgW摄入组中,游离脂肪酸(FFA)和β-羟基丁酸浓度(β-OHB)降低,糖代谢得到良好维持。同时,在OS摄入组中,FFA和β-OHB升高,脂肪分解开始。然而,即使摄入了ArgW,进入手术室后仍观察到FFA和β-OHB的反弹性升高。
未来应科学验证术前碳水化合物的最佳剂量和给药方法。