Abstract
BackroundAt present, low-concentration carbohydrate is rarely used in minor trauma surgery, and its clinical efficacy is unknown. The aim of the study was to evaluate the effect of preoperative oral low-concentration carbohydrate on patient-centered quality of recovery in patients undergoing thyroidectomy using Quality of Recovery − 15 (QoR-15) questionnaire.MethodsOne hundred twenty patients were randomized to oral intake of 300 ml carbohydrate solution (CH group) or 300 ml pure water (PW group) 2 h before surgery or fasting for 8 h before surgery (F group). The QoR-15 questionnaire was administered to compare the quality of recovery at 1d before surgery (T0), 24 h, 48 h, 72 h after surgery (T1, T2, T3), and perioperative blood glucose was recorded.ResultsCompared to the F group, the QoR-15 scores were statistically higher in the CH and PW group at T1 (P < 0.05), and the enhancement of recovery quality reached the clinical significance at T1 in the CH group compared with the F group. Among the five dimensions of the QoR-15 questionnaire, physical comfort, physiological support and emotional dimension in the CH group were significantly better than the F group (P < 0.05) at T1. Besides, blood glucose of CH group was significantly lower than the PW group and F group at each time point after surgery.ConclusionsLow-concentration carbohydrate could decrease the incidence of postoperative hyperglycemia and improve the patient-centered quality of recovery on patients undergoing open thyroidectomy at the early stage postoperatively.Trial registrationChiCTR1900024731. Date of registration: 25/07/2019.
Highlights
Preoperative oral carbohydrate, guided by the theory of enhanced recovery after surgery (ERAS), has been used in more and more surgical operations to improve the quality of postoperative recovery through improving perioperative comfort, decreasing postoperative insulin resistance, reducing the incidence of postoperative nausea and vomiting (PONV) and shortening the postoperative hospital stay [1,2,3]
All enrolled patients were divided into three groups and administered with preoperative oral carbohydrate (CH group), pure water (PW group), and 8 h fasting before surgery (F group) by using a webbased random-number generator on the day before surgery by the specific researcher who was only responsible for randomly grouping and implementing the intervention, the remaining researchers and the attending anesthesiologists were blinded to group assignment
From August 2019 to December 2019, 120 patients were screened for eligibility after applying the exclusion criteria and randomly assigned to three groups (CH, PW, and F group, n = 40)
Summary
Preoperative oral carbohydrate, guided by the theory of enhanced recovery after surgery (ERAS), has been used in more and more surgical operations to improve the quality of postoperative recovery through improving perioperative comfort, decreasing postoperative insulin resistance, reducing the incidence of postoperative nausea and vomiting (PONV) and shortening the postoperative hospital stay [1,2,3]. The degree of postoperative insulin resistance depends on the types of surgery, the postoperative insulin sensitivity of minor operations, such as laparoscopic cholecystectomy, is only 15 to 20% lower than that before surgery, while that of open cholecystectomy is about 75% lower than that before surgery [4, 5]. Perhaps it means we should adjust the concentration of carbohydrate according to the different types of surgery. Low-concentration carbohydrate may be sufficient to reduce insulin resistance and improve the quality of postoperative recovery for minor surgeries
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