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健康肥胖志愿者摄入碳水化合物饮料和水后胃残留量的比较:一项随机交叉研究。

Comparison of Gastric Residual Volume After Ingestion of A Carbohydrate Drink and Water in Healthy Volunteers with Obesity: A Randomized Crossover Study.

机构信息

Department of Anesthesiology, Faculty of Medicine, Prince of Songkla University, Hatyai, 90110, Songkhla, Thailand.

Department of Radiology, Faculty of Medicine, Prince of Songkla University, Hatyai, 90110, Songkhla, Thailand.

出版信息

Obes Surg. 2024 Oct;34(10):3813-3820. doi: 10.1007/s11695-024-07493-x. Epub 2024 Sep 5.

DOI:10.1007/s11695-024-07493-x
PMID:39235689
Abstract

INTRODUCTION

Preoperative carbohydrate intake is essential to enhance postoperative recovery. However, its safety for individuals with obesity remains unclear. This study investigated the safety of preoperative carbohydrate consumption compared to water intake in obese populations through gastric volume assessment.

METHODS

A prospective randomized crossover study enrolled 30 healthy volunteers aged 18-65 years with a body mass index ≥ 30 kg/m, following a minimum 6-h fast. The participants received either 400 ml of a carbohydrate drink (group C) or water (group W). Gastric ultrasonography, blood glucose level, hunger, and thirst assessments were conducted at baseline (T) and various time points (T2 to T6). The protocol was repeated with reverse interventions at least 1 week later.

RESULTS

Group C had significantly higher gastric volume at T3, T4, and T5 compared to group W, with a prolonged time to empty the gastric antrum (94.4 ± 28.5 vs. 61.0 ± 33.5 min, 95% CI 33.41 [17.06,24.69]). However, glucose levels, degrees of hunger, and thirst showed no significant differences between the groups.

CONCLUSION

Administering 400 ml of preoperative carbohydrates to healthy obese individuals 2 h preoperatively is safe and comparable to water intake. These findings support the integration of carbohydrate loading into perioperative care for obese individuals, consistent with the enhanced recovery after surgery protocols. Further research is warranted to refine preoperative fasting protocols and improve surgical outcomes in this population.

摘要

简介

术前碳水化合物摄入对于促进术后恢复至关重要。然而,对于肥胖人群,其安全性尚不清楚。本研究通过胃容量评估,调查了肥胖人群术前摄入碳水化合物与水相比的安全性。

方法

一项前瞻性随机交叉研究纳入了 30 名年龄在 18-65 岁之间、BMI≥30 kg/m²的健康志愿者,他们至少禁食 6 小时。参与者接受 400ml 的碳水化合物饮料(C 组)或水(W 组)。在基线(T)和不同时间点(T2 至 T6)进行胃超声检查、血糖水平、饥饿感和口渴感评估。至少在 1 周后,用相反的干预措施重复该方案。

结果

与 W 组相比,C 组在 T3、T4 和 T5 时胃容量明显更高,胃窦排空时间延长(94.4±28.5 vs. 61.0±33.5 分钟,95%CI33.41[17.06,24.69])。然而,两组之间的血糖水平、饥饿程度和口渴感没有显著差异。

结论

术前 2 小时给健康肥胖个体输注 400ml 碳水化合物是安全的,与水摄入相当。这些发现支持将碳水化合物负荷纳入肥胖个体围手术期管理,与术后恢复加速方案一致。需要进一步研究来完善术前禁食方案,改善该人群的手术结局。

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