Van Loi Do, Lam Nguyen Duc, Tuoi Tran Thi, Vinh Tran Vuong The
Department of Anesthesia, School of Medicine and Pharmacy, Phenikaa University, Hanoi, Vietnam.
Anesthesia Center, Phenikaa University Hospital, Hanoi Vietnam.
Medicine (Baltimore). 2025 Mar 14;104(11):e41865. doi: 10.1097/MD.0000000000041865.
Prolonged fasting before surgery is commonly practiced reducing the risk of pulmonary aspiration during anesthesia induction, but it can cause discomfort and negative recovery process. Preoperative carbohydrate intake, particularly maltodextrin solutions, has emerged as a strategy to enhance recovery while addressing these challenges.
This randomized controlled trial evaluated the safety and effectiveness of preoperative maltodextrin intake in 70 patients undergoing gynecological laparoscopic surgery. Participants were divided into 2 groups: a maltodextrin group (n = 35), who consumed a 15% maltodextrin solution (300 mL) 2 hours before surgery, and a fasting group (n = 33), who followed conventional overnight fasting. Key outcomes included gastric residual volume (GRV) and gastric pH, assessed via ultrasound and pH measurement.
The mean GRV per body weight was 0.62 ± 0.4 mL/kg in the maltodextrin group and 0.54 ± 0.3 mL/kg in the fasting group (P = .4), showing no significant difference. Gastric pH was 3.45 ± 1.62 in the maltodextrin group and 3.21 ± 1.58 in the fasting group (P = .11). No cases of aspiration or reflux were observed during anesthesia.
Preoperative maltodextrin consumption is a safe and effective alternative to traditional fasting, reducing discomfort without compromising patient safety. These findings support the integration of carbohydrate intake into enhanced recovery after surgery protocols to improve perioperative care and outcomes.
手术前长时间禁食是常见做法，可降低麻醉诱导期间肺误吸的风险，但会导致不适并影响恢复过程。术前摄入碳水化合物，尤其是麦芽糊精溶液，已成为一种既能应对这些挑战又能促进恢复的策略。
这项随机对照试验评估了70例接受妇科腹腔镜手术患者术前摄入麦芽糊精的安全性和有效性。参与者分为两组：麦芽糊精组（n = 35），在手术前2小时饮用15%麦芽糊精溶液（300毫升）；禁食组（n = 33），遵循传统的过夜禁食。主要结局包括通过超声和pH测量评估的胃残余容积（GRV）和胃pH值。
麦芽糊精组每体重的平均GRV为0.62±0.4毫升/千克，禁食组为0.54±0.3毫升/千克（P = 0.4），无显著差异。麦芽糊精组的胃pH值为3.45±1.62，禁食组为3.21±1.58（P = 0.11）。麻醉期间未观察到误吸或反流病例。
术前摄入麦芽糊精是传统禁食的一种安全有效的替代方法，可减少不适且不影响患者安全。这些发现支持将碳水化合物摄入纳入术后加速康复方案，以改善围手术期护理和结局。
