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一日手术患者围手术期碳水化合物负荷。随机对照试验的系统评价。

Perioperative carbohydrate loading in patients undergoing one-day surgery. A systematic review of randomized controlled trials.

作者信息

Kukliński Jakub, Steckiewicz Karol P, Owczuk Radosław

机构信息

Department of Anesthesiology and Intensive Therapy, Faculty of Medicine, Medical University of Gdansk, Gdansk, Poland.

出版信息

Wideochir Inne Tech Maloinwazyjne. 2022 Sep;17(3):457-466. doi: 10.5114/wiitm.2022.116750. Epub 2022 Jun 19.


DOI:10.5114/wiitm.2022.116750
PMID:36187066
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9511918/
Abstract

INTRODUCTION: It is suggested that preoperative carbohydrate loading may have beneficial effects, which is emphasised in Enhanced Recovery After Surgery protocols (ERAS). Recent data confirmed that carbohydrate loading shortens length of hospital stay. AIM: In this systematic review we aimed to determine whether carbohydrate loading have positive effects in patients undergoing 1-day surgery. MATERIAL AND METHODS: We searched 5 databases and identified some randomized controlled trials which were reviewed independently by two reviewers. In the end 6 RCTs were included, involving 411 patients. Studies compared effects of carbohydrate loading vs. fasting and/or placebo on the following outcomes: thirst, hunger, postoperative nausea and vomiting (PONV), fatigue, pain and postoperative insulin resistance. In most cases data are inconclusive as studies reported opposite results. CONCLUSIONS: It seems that carbohydrate loading did not have a significant impact when compared to fasting or placebo. Preoperative carbohydrate loading seems not to have significant benefits over fasting or placebo in patients qualified for 1-day surgery.

摘要

引言:有人提出术前碳水化合物负荷可能具有有益作用,这在术后加速康复方案(ERAS)中得到了强调。最近的数据证实,碳水化合物负荷可缩短住院时间。 目的:在本系统评价中,我们旨在确定碳水化合物负荷对接受日间手术的患者是否有积极影响。 材料与方法:我们检索了5个数据库,并确定了一些随机对照试验,由两名评价者独立进行评价。最终纳入了6项随机对照试验,涉及411例患者。研究比较了碳水化合物负荷与禁食和/或安慰剂对以下结局的影响:口渴、饥饿、术后恶心呕吐(PONV)、疲劳、疼痛和术后胰岛素抵抗。在大多数情况下,由于研究报告了相反的结果,数据尚无定论。 结论:与禁食或安慰剂相比,碳水化合物负荷似乎没有显著影响。对于适合日间手术的患者,术前碳水化合物负荷似乎并不比禁食或安慰剂有显著益处。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/07bb/9511918/70ca6aacda87/WIITM-17-47152-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/07bb/9511918/70ca6aacda87/WIITM-17-47152-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/07bb/9511918/70ca6aacda87/WIITM-17-47152-g001.jpg

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Perioperative carbohydrate loading in patients undergoing one-day surgery. A systematic review of randomized controlled trials.

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引用本文的文献

[1]
Recovery of gastrointestinal functional after surgery for abdominal tumors: A narrative review.

Medicine (Baltimore). 2024-11-1

[2]
Value of enhanced recovery after surgery in patients undergoing endoscopic retrograde cholangiopancreatography with intravenous anaesthesia for choledocholithiasis: a retrospective observational study.

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本文引用的文献

[1]
Effect of Carbohydrate-Enriched Drink Compared to Fasting on Hemodynamics in Healthy Volunteers. A Randomized Trial.

J Clin Med. 2022-2-4

[2]
The influence of fasting and carbohydrate-enriched drink administration on body water amount and distribution: a volunteer randomized study.

Perioper Med (Lond). 2021-8-10

[3]
ESPEN practical guideline: Clinical nutrition in surgery.

Clin Nutr. 2021-7

[4]
Effect of pre-operative oral carbohydrate loading on recovery after day-case cholecystectomy: A randomised controlled trial.

Eur J Anaesthesiol. 2019-8

[5]
Sugar rush or sugar crash? A meta-analysis of carbohydrate effects on mood.

Neurosci Biobehav Rev. 2019-4-3

[6]
Enhanced recovery after surgery-Preoperative fasting and glucose loading-A review.

J Surg Oncol. 2017-10

[7]
Network meta-analysis of the effect of preoperative carbohydrate loading on recovery after elective surgery.

Br J Surg. 2016-12-21

[8]
Post-operative nausea and vomiting: update on predicting the probability and ways to minimize its occurrence, with focus on ambulatory surgery.

Int J Surg. 2015-1-29

[9]
Effects of preoperative carbohydrates drinks on immediate postoperative outcome after day care laparoscopic cholecystectomy.

Surg Endosc. 2015-11

[10]
Fluid management and goal-directed therapy as an adjunct to Enhanced Recovery After Surgery (ERAS).

Can J Anaesth. 2015-2

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