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术前饮用高碳水化合物饮料(术前准备)对接受根治性前列腺切除术患者术后代谢应激反应的影响。

Effect of preoperative consumption of high carbohydrate drink (Pre-Op) on postoperative metabolic stress reaction in patients undergoing radical prostatectomy.

作者信息

Canbay Özgür, Adar Serdar, Karagöz Ayşe Heves, Çelebi Nalan, Bilen Cenk Yücel

机构信息

Department of Anesthesiology, Faculty of Medicine, Hacettepe University, Sıhhıye, 06100, Ankara, Turkey,

出版信息

Int Urol Nephrol. 2014 Jul;46(7):1329-33. doi: 10.1007/s11255-013-0612-y. Epub 2014 Feb 2.

Abstract

AIM

To investigate the effects of oral carbohydrate solution consumed until 2 h before the surgery in the patients that would undergo open radical retropubic prostatectomy on postoperative metabolic stress, patient anxiety, and comfort.

METHOD

A total of 50 adult patients, who were in ASA I-II group and would undergo open radical retropubic prostatectomy, were included in the study. While Group 1 = CH (n = 25) received oral glucose solution, Group 2 = FAM (n = 25) was famished starting from 24:00 h. Blood glucose, insulin, and procalcitonin levels of the patients were recorded, and the patients completed state-trait anxiety inventory (STAI) test, which reflects the anxiety level of the patients, both before surgery and on the postoperative 24th hour. In order to evaluate patient comfort, senses of hunger, thirst, nausea, and cold were assessed in the morning prior to the surgery.

RESULTS

No difference was observed between the two groups in terms of demographic data and insulin resistance levels (p > 0.05). Comparing with the preoperative levels, insulin resistance showed statistically significant elevation in both groups (p < 0.05). Procalcitonin levels were similarly increased in both groups in the postoperative period (p < 0.05). Preoperative and postoperative STAI state scores were similar in both groups (p > 0.05). With regard to preoperative patient comfort, sense of hunger was present in lesser number of subjects and at lower level in Group 1 (p < 0.05).

CONCLUSION

Preoperative consumption of high carbohydrate drink (Pre-op) decreases insulin resistance and enhances patient comfort leading to lesser sense of hunger and thirst in the preoperative period in open radical retropubic prostatectomies.

摘要

目的

探讨在接受开放性耻骨后根治性前列腺切除术的患者中,术前2小时饮用口服碳水化合物溶液对术后代谢应激、患者焦虑及舒适度的影响。

方法

本研究纳入了50例ASA I-II级、拟行开放性耻骨后根治性前列腺切除术的成年患者。第1组=CH(n = 25)饮用口服葡萄糖溶液,第2组=FAM(n = 25)从24:00起禁食。记录患者的血糖、胰岛素和降钙素原水平,患者在术前及术后第24小时完成反映焦虑水平的状态-特质焦虑量表(STAI)测试。为评估患者舒适度,在手术当天早晨评估饥饿、口渴、恶心和寒冷感。

结果

两组在人口统计学数据和胰岛素抵抗水平方面无差异(p>0.05)。与术前水平相比,两组胰岛素抵抗均有统计学显著升高(p<0.05)。两组术后降钙素原水平均同样升高(p<0.05)。两组术前和术后STAI状态评分相似(p>0.05)。关于术前患者舒适度,第1组中感到饥饿的受试者数量较少且程度较低(p<0.05)。

结论

在开放性耻骨后根治性前列腺切除术中,术前饮用高碳水化合物饮料可降低胰岛素抵抗,提高患者舒适度,使术前饥饿和口渴感减轻。

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