Yamada Tomomi, Mukai Nobuhiro, Tsuchida Keiichirou, Hayashi Kazuko
Masui. 2015 Apr;64(4):379-82.
Traditionally, perioperative nutritional management centered on fluid therapy, but in recent years, with the spread of enhanced recovery after surgery (ERAS) protocols, the utility of oral rehydration therapy (ORT) has been reported. There are few reports, however, on the safety of using jelly type oral rehydration solutions for ORT. We examined the effects of OS-1 jelly on gastric fluid and investigated its safety.
A total of 147 patients (age range, 4-91 years), scheduled for elective surgery at our institution for whom ORT was indicated, were enrolled in this study. If the surgery was scheduled for the morning, patients were given two bottles of 200 g OS-1 jelly during the previous evening meal. If surgery was scheduled for the afternoon, two additional 200 g bottles were given to the patient with the morning meal on the day of surgery. Patients were allowed to drink water until two hours before the surgery. Gastric fluid was aspirated with a gastric tube after anesthesia induction, after which, volume and pH were measured.
In all cases, gastric content was aspirated as a liquid, not a jelly. The volume and pH were 11.4 ± 14.6 ml and 2.8 ± 2.2, respectively. No major difference was seen in comparison with the data for OS-1 liquid. No postoperative aspiration pneumonia or reflux of gastric contents at the time of anesthesia induction was seen in any of the patients.
From the present findings, if the time of water intake is strictly controlled, preoperative rehydration therapy using jelly-type oral rehydration solution is thought to be safe and comparable to liquid solution regarding its effects on gastric fluid.
传统上,围手术期营养管理以液体疗法为中心,但近年来,随着术后加速康复(ERAS)方案的推广,口服补液疗法(ORT)的效用已有报道。然而,关于使用果冻型口服补液溶液进行ORT的安全性报道较少。我们研究了OS-1果冻对胃液的影响并调查了其安全性。
本研究纳入了147例计划在我院接受择期手术且需要ORT的患者(年龄范围4 - 91岁)。如果手术安排在上午,患者在前一晚晚餐时服用两瓶200克的OS-1果冻。如果手术安排在下午,在手术当天早餐时再给患者额外两瓶200克的果冻。患者在手术前两小时前可饮水。麻醉诱导后用胃管抽取胃液,然后测量其体积和pH值。
在所有病例中,胃内容物被抽吸为液体,而非果冻状。体积和pH值分别为11.4±14.6毫升和2.8±2.2。与OS-1液体的数据相比,未见明显差异。所有患者在麻醉诱导时均未出现术后吸入性肺炎或胃内容物反流。
根据目前的研究结果,如果严格控制饮水时间,术前使用果冻型口服补液溶液进行补液治疗被认为是安全的,并且在对胃液的影响方面与液体溶液相当。