Purpose This study aimed to evaluate the effect of preoperative carbohydrate oral (CHO) loading on the postoperative metabolic and inflammatory response, perioperative discomfort and surgical clinical outcomes in open colorectal surgery compared with a conventional fasting protocol. Methods Fifty patients were randomly allocated to either the intervention group (CHO), to receive preoperative oral carbohydrate supplementation, or the control group (FAST), to undergo preoperative fasting. Insulin resistance, insulin sensitivity, the Glasgow Prognostic Score (GPS) and IL-6 levels were analysed at 06 h on the day of surgery (T 1 ), 6 h after surgery (T 2 ) and at 06 h on postoperative day 1 (T 3 ) and postoperative day 2 (T 4 ). Thirst, hunger, dry mouth, weakness, anxiety and pain were assessed using the visual analogue scale (VAS) prior to anaesthesia induction and at 0-4, 4-8, 8-12 and 12-24 h after surgery. Surgical clinical outcomes included the return of gastrointestinal function, time to independent ambulation and postoperative discharge day. Results Postoperative insulin resistance was 30% lower (p < 0.03) and insulin sensitivity was 15% higher (p < 0.05) in the CHO group than in the FAST group. The GPS was lower in the CHO group at T 1 (p < 0.001), T 3 (p < 0.01) and T 4 (p < 0.004). IL-6 serum levels were lower at the analysed postoperative time points in the CHO group (p < 0.001). The VAS well-being score was lower in the intervention group (p < 0.001); however, the VAS pain score was not significantly different between the groups. The evaluated surgical outcomes appeared earlier in the CHO group (p < 0.001). Conclusion A preoperative CHO drink reduced the postoperative metabolic and inflammatory response and improved subjective well-being and surgical clinical outcomes but did not diminish the VAS pain score.

&lt;p&gt;&lt;strong&gt;Aim &lt;br /&gt;&lt;/strong&gt;To compare the quality of the conditions for endotracheal intubation and muscle relaxation between rocuronium bromide and vecuronium bromide using the &#039;&#039;timing principle&#039;&#039; method for induction in anaesthesia. The &quot;timing principle&quot; includes the administration of muscle relaxants before the hypnotic agent during induction in anaesthesia. &lt;br /&gt;&lt;strong&gt;Method&lt;br /&gt;&lt;/strong&gt; Sixty patients who had undergone elective surgery were randomly allocated into two equal groups using muscle relaxants: rocuronium (group R) and vecuronium (group V). The intubation conditions were asse ssed using Cooper&#039;s scoring system, based on jaw relaxation, vocal cords position and response to intubation. The quality of muscle relaxation was evaluated by recording the time of clinical weakness, a count of &#039;&#039;train of four&#039;&#039; (TOF) twitches at intubation, the time of loss TOF response and duration of direct laryngoscopy. &lt;br /&gt;&lt;strong&gt;Results&lt;br /&gt;&lt;/strong&gt; The intubation conditions were excellent in 100% of patients in the group R versus excellent in 80% and good in 20% of patients in the group V (p&amp;lt;0.05). The time of clinical weakness was statistically significantly shorter in the group R than in the group V (p&amp;lt;0.000). The time of loss of TOF response was statistically significantly shorter in the group R (p&amp;lt;0.000). The absence of TOF twitches (the level of muscle relaxation of 100%) at intubation recorded in 25 (83.3%) patients in the group R versus five (16.7%) patients in the group V (p&amp;lt;0.000). Duration of direct laryngoscopy did not significantly differ between the groups. &lt;br /&gt;&lt;strong&gt;Conclusion&lt;br /&gt;&lt;/strong&gt; Rocuronium bromide provides better intubation conditions and greater quality of muscle relaxation than vecuronium bromide using &#039;&#039;timing principle&#039;&#039; technique.&lt;/p&gt;

&lt;p&gt;&lt;strong&gt;Aim&lt;/strong&gt; &lt;br /&gt;To compare the effects of endotracheal tube cuff inflation media, air, saline and alkalinized 2% lidocaine on increase of cuff pressure (CP) during nitrous oxide maintained anaesthesia and on incidence of postoperative throat symptoms (PTS), and to evaluate the incidence of postoperative throat mucosal injuries (PTMI) depending on cuff inflation medium. &lt;br /&gt;&lt;strong&gt;Methods&lt;/strong&gt; &lt;br /&gt;Ninety patients who had undergone elective surgery were randomly allocated into 3 equal groups per cuff inflation media: air (group A), saline (group S) and alkalinized 2% lidocaine (group L). The CP was monitored immediately after cuff inflation and further 5, 15, 30, 60 and 90 minutes after intubation. The incidence and intensity of PTS, sore throat, hoarseness, dysphagia and cough were evaluated 2, 6 and 24 hours after extubation. The incidence and intensity of PTMI were evaluated 24 hours after exubation using indirect laryngoscopy examination. &lt;br /&gt;&lt;strong&gt;Results&lt;br /&gt;&lt;/strong&gt; The highest increase of mean CP was recorded in the group A (18.7&amp;plusmn;4.9), it was significantly lower (6.4&amp;plusmn;1.1) in the group S, while it remained stable in the group L (0.7&amp;plusmn;0.7). All PTS occurred less frequently in the group L: sore throat (p&amp;lt;0.001), hoarseness and dysphagia (p&amp;lt;0.05), but the incidence of cough was not significantly different between the groups. The lowest incidence of PTMI was in the group L (p&amp;lt;0.001). &lt;br /&gt;&lt;strong&gt;Conclusion&lt;br /&gt;&lt;/strong&gt;The increase of CP contributed to incidence of PTS. The intracuff alkalinized 2% lidocaine was superior to saline and air in the prevention of an increase of CP and reduction of the PTS incidence. There was a strong correlation between the incidence of PTS and PTMI.&lt;/p&gt;

To compare intubation conditions and hemodynamic response of two induction regimens, with or without muscle relaxant using a combination of either fentanyl and propofol or propofol and suxamethonium.