Department of Anesthesiology, The Seventh Affiliated Hospital of Sun Yat-Sen University, Shenzhen City, People's Republic of China.
Department of Anesthesiology, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou City, People's Republic of China.
J Perianesth Nurs. 2023 Aug;38(4):579-584. doi: 10.1016/j.jopan.2022.09.011. Epub 2023 Feb 1.
In our previous study, hypokalemia incidence was high in patients scheduled for laparoscopic colorectal resection. This trial was conducted to verify the effects of preoperative carbohydrate drinks containing potassium in these patients.
A three-arm randomized controlled design was used.
Patients were randomly assigned to control, placebo, and treatment groups. In the control group, patients fasted from midnight. In the placebo group, patients fasted from midnight and received carbohydrate drinks 2 to 3 hours before surgery. In the treatment group, patients fasted from midnight and received carbohydrate drinks containing potassium supplementation 2 to 3 hours before surgery. The primary outcome was the incidence and severity of preoperative hypokalemia. Other outcomes included postoperative gastrointestinal function, including the time to postoperative first flatus (FFL) and first feces (FFE), and other complications.
The final analysis included 122 participants. The incidence of preoperative hypokalemia in the treatment group was significantly lower than that in the control and placebo groups (50% vs 88.1% vs 77.5%, P < .001). The severity of hypokalemia in the control and placebo groups was greater than that in the treatment group. No regurgitation or aspiration occurred in the three groups. No significant differences were observed among the three groups regarding time to FFL and FFE.
Preoperative carbohydrate drinks containing potassium significantly reduced the incidence of preoperative hypokalemia and improved preoperative thirst and hunger, but did not reduce the postoperative time to FFL and FFE or length of hospital stay. However, as part of the enhanced recovery after surgery protocol, preoperative carbohydrate drinks containing potassium should be considered, as early as first admittance to hospital.
在我们之前的研究中，接受腹腔镜结直肠切除术的患者低钾血症的发生率较高。本试验旨在验证术前含钾碳水化合物饮料对这些患者的作用。
采用三臂随机对照设计。
患者被随机分配至对照组、安慰剂组和治疗组。对照组患者午夜开始禁食，安慰剂组患者午夜开始禁食，并于术前 2-3 小时接受碳水化合物饮料，治疗组患者午夜开始禁食，并于术前 2-3 小时接受含钾补充的碳水化合物饮料。主要结局是术前低钾血症的发生率和严重程度。其他结局包括术后胃肠功能，包括术后首次肛门排气（FFL）和首次排便（FFE）的时间，以及其他并发症。
最终分析纳入 122 名患者。治疗组术前低钾血症的发生率明显低于对照组和安慰剂组（50% vs 88.1% vs 77.5%，P<0.001）。对照组和安慰剂组的低钾血症严重程度大于治疗组。三组均无反流或误吸。三组间 FFL 和 FFE 的时间无显著差异。
术前含钾碳水化合物饮料可显著降低术前低钾血症的发生率，改善术前口渴和饥饿感，但不会减少术后 FFL 和 FFE 的时间或住院时间。然而，作为术后加速康复方案的一部分，应考虑术前含钾碳水化合物饮料，尽早在住院时开始使用。
