Evaluation of effects of a preoperative 2-hour fast with glutamine and carbohydrate rich drink on insulin resistance in maxillofacial surgery.

INTRODUCTION

The aim of this prospective, randomized, single-blinded study was to compare the effects of preoperative fast for clear fluids on insulin resistance and hemodynamic stability on patient undergoing maxillofacial surgery.

METHOD

In this study 20 patients undergoing maxillofacial surgery were randomized into four groups i.e. - group I patients with standard 08 h fasting before anesthesia, group-II patients were given 400 ml and 200 ml of water 08 h and 2 h respectively before anesthesia, group III patients were given 400 ml water with 50 gms of glucose and 40 gm of glutamine 08 h before anesthesia and 200 ml water with 25 gms of glucose and 10 gm of glutamine 2 h before anesthesia, group IV patients were given 400 ml water with 50 gms of glucose 08 h before anesthesia and 200 ml water with 25 gms of glucose 2 h before anesthesia. Blood samples were collected pre-operatively and post-operatively.

RESULTS

Overall results suggest that Post-operative insulin resistance was greater in control patients (2.0 [0.3]) compared with the other 3 groups (placebo = 1.8 [0.9]); glutamine = (1.8 [0.6]); carbohydrate = (1.9 [0.6]).

DISCUSSION

This study shows that shortening of pre-operative fasting time for clear fluids until 2- h prior to anesthesia may induce a favorable environment for the post-operative course. In conclusion, Glutamine with carbohydrate drink can be used safely in surgical patients.