Abstract
Objective: To investigate the safety of preoperative oral carbohydrate and the impact of preoperative oral carbohydrate on postoperative insulin resistance. Methods: 60 patients with gastric cancer scheduled were randomly divided into preoperative oral carbohydrate or placebo drink. Preoperative general well-being, 2-3 hours before the induction of anesthesia all patients received either a placebo drink or carbohydrate drink, blood glucose, insulin were measured before and immediately after surgery, Insulin resistance index was calculated using Homeostasis Model Assessment (HOMA), and postoperative complications and length of hospital stay were respectively recorded. Results: No complications associated with anesthesia were recorded as a result of preoperative fluid consumption. In the two groups, blood glucose, insulin and HOMA-IR immediately postoperative in the preoperative oral carbohydrate group were significantly lower than those in the preoperative oral placebo group. Insulin sensitivity index (ISI) was reduced in both groups; the oral carbohydrate group was higher than oral placebo group. There were no differences between two groups on length of hospital stay. Conclusion: Preoperative consumption of carbohydrate-containing fluid is safe. Preoperative oral carbohydrate may alleviate the postoperative immediately insulin resistance should be a routine for preoperative preparation.
Highlights
Elective surgery is one of the treatments for modern medicine
This study is to prove the safety of preoperative oral carbohydrate and the effects of preoperative oral carbohydrate on postoperative insulin resistance and clinical outcome
Sixty patients underwent radical distal gastrectomy were recruited in this study
Summary
Elective surgery is one of the treatments for modern medicine. In the developed countries, about 5% of population will undergo elective operation every year. Elective surgery has been performed in the overnight fasted state. Preoperative fasting has been viewed as the general rule. This means that no intake of solids or fluids is followed from midnight to the time of surgery. The reasonable for preoperative fasting is that it ensures an empty stomach before operation and reduces the risk of pulmonary aspiration of gastric contents during surgery. Since 1848, when a young woman died from pulmonary aspiration, this was the first reported death following general anesthesia [1]. The overnight fasting routine depletes liver glycogen store, face to increase metabolic demands of surgery, this fasting state at the beginning of the operation may have a detrimental effect on clinical outcome [2]
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