Obstetrics Department, Women's Hospital, Zhejiang University School of Medicine, Hangzhou, China.
Medicine Department, Zhejiang University School of Medicine, Hangzhou, China.
J Obstet Gynaecol Res. 2021 Apr;47(4):1272-1280. doi: 10.1111/jog.14653. Epub 2021 Jan 5.
To investigate the safety and feasibility of taking low-concentration carbohydrate solution at 2 h before induction of anesthesia for gestational diabetes mellitus (GDM) patients.
GDM patients undergoing cesarean section were randomly assigned to experimental group (n = 43) and control group (n = 42). Two hours before induction of anesthesia, participants in experimental group orally received 300 mL low-concentration carbohydrate solution, while those in control group received equivalent warm water. Blood glucose and serum insulin were measured at 2 h before induction of anesthesia, right before induction of anesthesia, and the morning of postoperative day 1. Neonatal blood glucose level was monitored at birth. Maternal gastrointestinal function and well-being were assessed perioperatively.
The levels of blood glucose and serum insulin right before induction of anesthesia in the experimental group were significantly higher than those in the control group. There were four cases with hypoglycemia in the experimental group and 19 cases in the control group right before induction of anesthesia (9.3% vs 45.2%, p < 0.001). The incidence of neonatal hypoglycemia was 2.3% in the experimental group and 7.1% in the control group with no significance. Hunger score of the participants between the two groups right before induction of anesthesia was significantly different. No aspiration, nausea, and vomiting occurred in both groups before, during, and after surgery. No significant difference was found in the time to the first flatus and abdominal distension between the two groups.
Taking low-concentration carbohydrate solution is safe and feasible for patients with GDM undergoing elective cesarean section.
探讨妊娠期糖尿病（GDM）患者麻醉诱导前 2 小时服用低浓度碳水化合物溶液的安全性和可行性。
将择期行剖宫产术的 GDM 患者随机分为实验组（n=43）和对照组（n=42）。实验组患者在麻醉诱导前 2 小时口服 300ml 低浓度碳水化合物溶液，对照组患者则给予等量温水。分别于麻醉诱导前 2 小时、麻醉诱导前即刻和术后第 1 天清晨测量血糖和血清胰岛素水平。记录新生儿出生时的血糖水平。记录围手术期产妇的胃肠功能和舒适度。
实验组麻醉诱导前即刻的血糖和血清胰岛素水平明显高于对照组。实验组有 4 例出现低血糖，对照组有 19 例出现低血糖（9.3% vs. 45.2%，p<0.001）。实验组新生儿低血糖发生率为 2.3%，对照组为 7.1%，差异无统计学意义。两组患者麻醉诱导前即刻的饥饿评分差异有统计学意义。两组患者均未发生术中、术后恶心、呕吐和误吸。两组患者首次肛门排气和腹胀的时间差异无统计学意义。
对于择期行剖宫产术的 GDM 患者，服用低浓度碳水化合物溶液是安全可行的。
