术前口服碳水化合物负荷对日间胆囊切除术恢复的影响：一项随机对照试验。
Effect of pre-operative oral carbohydrate loading on recovery after day-case cholecystectomy: A randomised controlled trial.
机构信息
From the Department of Surgery and Anaesthesia, Seinäjoki Central Hospital, Seinäjoki (HH, HB, PO, JS) and Department of Surgery and Biostatistics, Oulu University Hospital, Oulu, Finland (HH, HB, PO, JS).
出版信息
Eur J Anaesthesiol. 2019 Aug;36(8):605-611. doi: 10.1097/EJA.0000000000001002.
BACKGROUND
Pre-operative carbohydrate loading has been shown to reduce pre-operative discomfort and postoperative nausea and vomiting in general surgical patients. Few studies have considered day-case surgery.
OBJECTIVE
The aim of this prospective randomised study was to determine whether pre-operative carbohydrate loading enhanced recovery after day-case cholecystectomy.
DESIGN
A randomised controlled trial.
SETTING
Secondary care in a district general and a university hospital in Finland between 2013 and 2016.
PATIENTS
A total of 113 patients American Society of Anesthesiologists physical status I or II aged 18 to 70 undergoing day-case cholecystectomy were included in the study. Exclusion criteria were bleeding or coagulation disorders, BMI more than 40 kg m, dementia, insulin-treated diabetes, migraine, Meniere's disease or a history of alcohol or drug abuse.
INTERVENTION
The carbohydrate-rich drink group received oral carbohydrate (200 ml) 2 to 3 h before surgery, and the control (fasting) group fasted from midnight according to standard protocol.
MAIN OUTCOME MEASURES
Visual analogue scales (VAS) were used to score six forms of discomfort: the need for analgesia and antiemetics, the time to drinking, eating and first mobilisation after surgery and the time to discharge. Any hospital re-admission was also recorded.
RESULTS
The highest VAS scores were seen for mouth dryness and tiredness 2 h after surgery in the fasting group. There were no significant differences in any VAS scores between the study groups. No differences in time to mobilisation, need for pain or antiemetic medication or time to discharge were seen between the groups.
CONCLUSION
Compared with overnight fasting, pre-operative carbohydrate loading did not significantly enhance peri-operative well being or recovery in patients undergoing day-case cholecystectomy.
TRIAL REGISTRATION
Clinicaltrials.gov Identifier: NCT03757208.
背景
术前碳水化合物负荷已被证明可减少普通外科患者术前不适和术后恶心呕吐。很少有研究考虑日间手术。
目的
本前瞻性随机研究旨在确定术前碳水化合物负荷是否能促进日间胆囊切除术患者的术后恢复。
设计
随机对照试验。
设置
芬兰一家地区综合医院和一家大学医院的二级护理，时间为 2013 年至 2016 年。
患者
共有 113 名美国麻醉医师协会身体状况 I 或 II 级、年龄在 18 至 70 岁之间的患者接受日间胆囊切除术，纳入本研究。排除标准为出血或凝血障碍、BMI 超过 40kg/m、痴呆、胰岛素治疗的糖尿病、偏头痛、梅尼埃病或酒精或药物滥用史。
干预
富含碳水化合物的饮料组在手术前 2 至 3 小时口服碳水化合物（200ml），而对照组（禁食）根据标准方案从午夜开始禁食。
主要观察指标
使用视觉模拟量表（VAS）对六种不适形式进行评分：对镇痛和止吐药物的需求、术后开始饮水、进食和首次活动的时间以及出院时间。还记录了任何医院再入院的情况。
结果
在禁食组，术后 2 小时口渴和疲劳的 VAS 评分最高。两组间任何 VAS 评分均无显著差异。两组间活动、疼痛或止吐药物需求或出院时间无差异。
结论
与隔夜禁食相比，术前碳水化合物负荷并未显著改善日间胆囊切除术患者围手术期的舒适度和恢复情况。
试验注册
Clinicaltrials.gov 标识符：NCT03757208。
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