胸外科手术患者术前碳水化合物负荷：一项质量改进项目。
Preoperative Carbohydrate Loading in Patients Undergoing Thoracic Surgery: A Quality-Improvement Project.
作者信息
Pachella Laura A, Mehran Reza J, Curtin Kimberly, Schneider Susan M
出版信息
J Perianesth Nurs. 2019 Dec;34(6):1250-1256. doi: 10.1016/j.jopan.2019.05.007. Epub 2019 Aug 21.
PURPOSE
The purpose of this project was to implement carbohydrate loading in patients undergoing thoracic surgery in an effort to decrease postoperative pain, nausea, and length of stay as a part of an enhanced recovery after surgery protocol.
DESIGN
This quality-improvement project used a preintervention and postintervention design.
METHODS
Carbohydrate loading was given to 50 patients before undergoing thoracic surgery. Chart review was performed for 47 patients who received standard preoperative instructions in the preintervention group as historical control.
FINDINGS
Patients who received carbohydrate loading had a decreased use of opioids in the first 4 hours after surgery (P = .028) and decreased use of antiemetic medication in the first 24 hours after surgery compared with the preintervention group (P = .066). Patients who were instructed to consume carbohydrate loading complied 87% of the time.
CONCLUSIONS
Carbohydrate loading can decrease postoperative nausea and pain in patients undergoing thoracic surgery.
目的
本项目的目的是在胸外科手术患者中实施碳水化合物负荷法，以作为术后加速康复方案的一部分，努力减轻术后疼痛、恶心并缩短住院时间。
设计
本质量改进项目采用干预前和干预后设计。
方法
50例患者在接受胸外科手术前进行碳水化合物负荷法。对干预前组中47例接受标准术前指导的患者进行病历审查作为历史对照。
结果
与干预前组相比，接受碳水化合物负荷法的患者术后首4小时阿片类药物使用量减少（P = 0.028），术后首24小时抗呕吐药物使用量减少（P = 0.066）。接受碳水化合物负荷法指导的患者87%的时间依从。
结论
碳水化合物负荷法可减轻胸外科手术患者的术后恶心和疼痛。
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