Xuzhou Medical University, Xuzhou, Jiangsu, 221004, China.
Department of Anesthesiology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, 221002, China.
Langenbecks Arch Surg. 2024 Sep 10;409(1):275. doi: 10.1007/s00423-024-03468-9.
Traditional fasting causes considerable discomfort without added assurance of security, whereas oral carbohydrate beverage offers an alternative to improve medical experience. This study aims to explore the impact of different types and dosages of oral fluids loading before painless bidirectional endoscopy on the gastric emptying and wellbeing.
180 patients arranged for bidirectional endoscopy with intravenous anesthesia were randomized: patients in the control group (Group C) obeyed standard fasting; the 200 mL carbohydrate group (Group P1), 400 mL carbohydrate group (Group P2), 200 mL water group (Group W1) and 400 mL water group (Group W2) respectively consumed 200 mL or 400 mL corresponding clear liquids 2 h before the procedure. Gastric emptying metrics under ultrasound, subjective comfort indexes, periprocedural blood glucose and vital signs were contrasted among the groups.
No significant differences were detected in the gastric emptying including CSA (cross-sectional area), GV (gastric volume), cGV (corrected gastric volume) and the three-point grading system among groups, and none had a cGV > 1.5 mL/kg before anesthesia. Participants in Group P2 experienced less preprocedural thirst and mouth dryness, so as the postprocedural thirst, mouth dryness and hunger. Periprocedural blood glucose and MAP had the similar trend in all groups. The occurrence of hypotension, bradycardia, hypoxia, and the required norepinephrine was comparable among the groups.
Oral beverage loading with 200 mL or 400 mL can be safely applicated 2 h before painless bidirectional endoscopy without increasing the gastric volume. 400 mL carbohydrate solution effectively relieves the discomfort and could serve as a consideration.
Registered in the Chinese Clinical Trial Registry on December 5, 2023 (ChiCTR2300078319).
传统禁食会引起相当大的不适，而且不能保证安全，而口服碳水化合物饮料则是一种改善医疗体验的替代方法。本研究旨在探讨无痛双向内镜检查前不同类型和剂量的口服液体负荷对胃排空和舒适度的影响。
将 180 例接受静脉麻醉下双向内镜检查的患者随机分组：对照组（C 组）患者遵医嘱禁食；200mL 碳水化合物组（P1 组）、400mL 碳水化合物组（P2 组）、200mL 水组（W1 组）和 400mL 水组（W2 组）分别在检查前 2h 饮用 200mL 或 400mL 相应的清亮液体。对比各组患者的胃超声排空指标、主观舒适度指标、围手术期血糖和生命体征。
各组患者的胃排空指标包括 CSA（横截面积）、GV（胃容量）、cGV（校正胃容量）和三点分级系统均无显著差异，且麻醉前均无 cGV＞1.5mL/kg。P2 组患者术前口渴和口干程度较轻，术后口渴、口干和饥饿感较轻。各组围手术期血糖和 MAP 均呈相似趋势。各组低血压、心动过缓、缺氧和需要去甲肾上腺素的发生率相似。
无痛双向内镜检查前 2h 口服 200mL 或 400mL 饮料可安全应用，不会增加胃容量。400mL 碳水化合物溶液能有效缓解不适，可作为一种考虑因素。
于 2023 年 12 月 5 日在中国临床试验注册中心注册（ChiCTR2300078319）。
