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术前口服含碳水化合物饮料对门诊手术患者的影响:一项随机对照、双盲研究。

Effects of a Preoperative Carbohydrate-Rich Drink Before Ambulatory Surgery: A Randomized Controlled, Double-Blinded Study.

机构信息

Department of Anesthesiology, Xiangya Hospital Central South University, Changsha, Hunan, China (mainland).

出版信息

Med Sci Monit. 2020 Aug 28;26:e922837. doi: 10.12659/MSM.922837.

Abstract

BACKGROUND The guidelines recommend oral carbohydrates up to 2 hr before elective surgery. The objective of this study was to explore the safety and feasibility of preoperative carbohydrate drink in patients undergoing ambulatory surgery. MATERIAL AND METHODS Patients undergoing ambulatory surgery under general anesthesia were enrolled. They were fasted from midnight and randomly assigned to a study group (200 mL of a carbohydrate beverage) or the control group (pure water) and received the assigned drink 2 hr before surgery. Bedside ultrasonography was performed to monitor gastric emptying at T₀ (before liquid intake), T₁ (5 min after intake), T₂ (1 hr after intake), and T₃ (2 hr after intake). Subjective feelings of thirst, hunger, anxiety, and fatigue were assessed 1 hr after liquid intake using the visual analogue scale (VAS). RESULTS In both groups, gastric antrum cross-sectional area, gastric content volume, and weight-corrected gastric content volume increased at T₁ and returned to baseline at T₃. These parameters were significantly higher in the study group at T₂ (6.28±1.38 vs. 4.98±0.78, 67.22±29.49 vs. 49.04±15.4, 1.10±0.51 vs. 0.85±0.37, P<0.05). Thirst and hunger VAS scores were reduced in both groups. The study group suffered significantly less hunger (28.44±10.41 vs. 36.03±14.42, P<0.05). Blood electrolytes (sodium, potassium, calcium) and glucose concentration levels were similar in both groups at T₂. No gastric regurgitation or pulmonary aspiration was recorded. CONCLUSIONS Administration of 200 mL of oral carbohydrate beverage 2 hr before ambulatory surgery is safe, effective, and can be used for preoperative management of fasting patients.

摘要

背景

指南建议在择期手术前 2 小时口服碳水化合物。本研究的目的是探讨在接受全身麻醉的门诊手术患者中术前给予碳水化合物饮料的安全性和可行性。

材料和方法

纳入接受全身麻醉的门诊手术患者。他们从午夜开始禁食,并随机分为研究组(200 毫升碳水化合物饮料)或对照组(纯净水),并在手术前 2 小时给予所分配的饮料。在 T₀(液体摄入前)、T₁(摄入后 5 分钟)、T₂(摄入后 1 小时)和 T₃(摄入后 2 小时)进行床边超声检查以监测胃排空。在摄入液体后 1 小时使用视觉模拟量表(VAS)评估口渴、饥饿、焦虑和疲劳的主观感受。

结果

在两组中,胃窦横截面积、胃内容物量和重量校正的胃内容物量在 T₁时增加,并在 T₃时恢复到基线。在 T₂时,研究组的这些参数显著更高(6.28±1.38 比 4.98±0.78、67.22±29.49 比 49.04±15.4、1.10±0.51 比 0.85±0.37,P<0.05)。两组的口渴和饥饿 VAS 评分均降低。研究组的饥饿感明显减轻(28.44±10.41 比 36.03±14.42,P<0.05)。在 T₂时,两组的血电解质(钠、钾、钙)和血糖浓度水平相似。未记录到胃反流或肺吸入。

结论

在门诊手术前 2 小时给予 200 毫升口服碳水化合物饮料是安全、有效的,可以用于禁食患者的术前管理。

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