Department of Anesthesiology, University of Florida College of Medicine, 1600 SW Archer Road, PO Box 100254, Gainesville, FL, 32610, USA.
Department of Obstetrics and Gynecology, University of Florida College of Medicine, Gainesville, FL, USA.
Arch Gynecol Obstet. 2020 Jan;301(1):179-187. doi: 10.1007/s00404-020-05455-z. Epub 2020 Feb 5.
Oral carbohydrate consumption before surgery improves insulin sensitivity, cardiac output and well-being, and shortens hospital stays without adverse effects. No work has compared higher-dose carbohydrate beverages made for preoperative consumption to common, commercial oral rehydration solutions with lower carbohydrate concentrations.
We recruited low-risk women undergoing scheduled cesarean deliveries with planned spinal anesthesia. Participants were randomized to one of three groups: those who consumed Clearfast beverage, those who consumed Gatorade Thirst Quencher beverage, or fasting control. Participants in the two beverage groups received 710 mL of the appropriate beverage the night before surgery and 355 mL 2 h before surgery. Participants in the control group fasted after midnight the night before surgery. Two hours before surgery, we recorded baseline patient well-being using visual analogue scales, followed by beverage consumption for subjects in the beverage groups. One hour later, we repeated the same assessment. Additional recorded measures included cord blood glucose level, intraoperative variables, breastfeeding success, and a quality of recovery assessment administered 1 day after surgery.
Forty-seven patients were recruited: 15 received Clearfast, 17 received Gatorade Thirst Quencher, and 15 patients fasted after midnight. Group differences in change in patient well-being using visual analog scales were analyzed using linear regression. Both beverage-consuming groups showed significant improvements in patient well-being using visual analog scales while fasted patients showed no change.
Either a common oral rehydration beverage or a higher-dose carbohydrate beverage consumed preoperatively resulted in superior well-being compared to fasting. No differences in other outcomes were noted.
This study was registered on ClinicalTrials.gov with clinical trial registration number: NCT02684513.
手术前口服碳水化合物可提高胰岛素敏感性、心输出量和舒适度，并缩短住院时间，且无不良反应。尚无研究比较术前使用的高剂量碳水化合物饮料与低浓度碳水化合物的普通商业口服补液溶液。
我们招募了计划行择期剖宫产术且拟行椎管内麻醉的低危女性。参与者被随机分为三组：饮用 Clearfast 饮料组、饮用佳得乐口渴终结者饮料组或禁食对照组。前两组在手术前夜和手术前 2 小时分别饮用 710 毫升和 355 毫升相应饮料，对照组在手术前夜午夜后禁食。手术前 2 小时，我们使用视觉模拟评分法记录患者基线舒适度，然后让饮料组患者饮用饮料。1 小时后，我们重复同样的评估。记录的其他指标包括脐血血糖水平、术中变量、母乳喂养成功率以及术后 1 天进行的恢复质量评估。
共招募了 47 名患者：15 名患者接受 Clearfast 治疗，17 名患者接受 Gatorade Thirst Quencher 治疗，15 名患者午夜后禁食。使用线性回归分析了视觉模拟评分法中患者舒适度变化的组间差异。在禁食状态下，两组饮用饮料的患者舒适度均显著改善，而禁食患者则无变化。
与禁食相比，术前饮用普通口服补液溶液或高剂量碳水化合物饮料可显著改善舒适度。其他结果无差异。
本研究在 ClinicalTrials.gov 上注册，注册号为 NCT02684513。
