Effects of oral carbohydrate with amino acid solution on the metabolic status of patients in the preoperative period: a randomized, prospective clinical trial

Tsutsumi, Rie; Kakuta, Nami; Kadota, Takako; Oyama, Takuro; Kume, Katsuyoshi; Hamaguchi, Eisuke; Niki, Noriko; Tanaka, Katsuya; Tsutsumi, Yasuo M.

doi:10.1007/s00540-016-2217-y

Cited by 20 publications

(30 citation statements)

References 37 publications

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“…[12,13] Preoperative oral carbohydrate intake also improves patient-reported outcomes such as hunger before the induction of anesthesia. [14,15] In line with previous studies, the present study also showed that patients treated with preoperative oral carbohydrates had lower thirst and hunger scores. However, carbohydrates with potassium were not superior to carbohydrates without potassium in terms of prognosis, although they significantly reduced the incidence of preoperative hypokalemia without changing the flavor of the fluid.…”

Section: Discussionsupporting

confidence: 92%

Effects of preoperative oral carbohydrate electrolyte drinks on preoperative hypokalemia incidence in patients scheduled for laparoscopic colorectal resection: a randomized clinical trial

Tan

Deng

et al. 2020

Preprint

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Background:In our previous study, hypokalemia incidence was high in patients scheduled for laparoscopic colorectal resection. The present trial was conducted to verify the effects of preoperative carbohydrate drinks containing potassium in these patients. Methods: Patients were randomly assigned to control, placebo, and case groups. In control group, patients were fasted from midnight. In placebo group, patients were fasted from midnight and received carbohydrate drinks 2–3 h before surgery. In case group, patients were fasted from midnight and received carbohydrate drinks containing potassium supplementation 2–3 h before surgery. The primary outcome was the incidence and severity of preoperative hypokalemia. The other outcomes included postoperative gastrointestinal function, including the time to postoperative first flatus (FFL) and first feces (FFE) and other complications. Results: The final analysis included 122 participants. The incidence of preoperative hypokalemia in case group was significantly lower than that in control and placebo groups (50% vs. 88.1% vs. 77.5%, p < 0.001). The severity of hypokalemia in control and placebo groups was greater than that in case group. No regurgitation or aspiration occurred in the three groups. No significant differences were observed among the three groups regarding time to FFL and FFE. Conclusions: Preoperative carbohydrate drinks containing potassium may have significantly reduced the incidence of preoperative hypokalemia and improved preoperative thirst and hunger, but did not improve postoperative well-being. However, as part of the enhanced recovery after surgery protocol, preoperative carbohydrate drinks containing potassium should be recommended, as early as first admittance to hospital.

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Section: Discussionsupporting

confidence: 92%

Effects of preoperative oral carbohydrate electrolyte drinks on preoperative hypokalemia incidence in patients scheduled for laparoscopic colorectal resection: a randomized clinical trial

Tan

Deng

et al. 2020

Preprint

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show abstract

“…Patients with normal uid and electrolyte balance are likely to experience stable induction of anesthesia [12,13]. Preoperative oral carbohydrate intake also improves patient-reported outcomes such as hunger before the induction of anesthesia [14,15]. In line with previous studies, the present study also showed that patients treated with preoperative oral carbohydrates had lower thirst and hunger scores.…”

Section: Discussionsupporting

confidence: 88%

Effects of Preoperative Oral Carbohydrate Electrolyte Drinks on Preoperative Hypokalemia Incidence in Patients Scheduled for Laparoscopic Colorectal Resection: A Randomized Clinical Trial

Tan¹,

Deng²,

Hu³

et al. 2020

Preprint

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Background: In our previous study, hypokalemia incidence was high in patients scheduled for laparoscopic colorectal resection. The present trial was conducted to verify the effects of preoperative carbohydrate drinks containing potassium in these patients.Methods: Patients were randomly assigned to control, placebo, and case groups. In control group, patients were fasted from midnight. In placebo group, patients were fasted from midnight and received carbohydrate drinks 2–3 h before surgery. In case group, patients were fasted from midnight and received carbohydrate drinks containing potassium supplementation 2–3 h before surgery. The primary outcome was the incidence and severity of preoperative hypokalemia. The other outcomes included postoperative gastrointestinal function, including the time to postoperative first flatus (FFL) and first feces (FFE) and other complications. Results: The final analysis included 122 participants. The incidence of preoperative hypokalemia in case group was significantly lower than that in control and placebo groups (50% vs. 88.1% vs. 77.5%, p < 0.001). The severity of hypokalemia in control and placebo groups was greater than that in case group. No regurgitation or aspiration occurred in the three groups. No significant differences were observed among the three groups regarding time to FFL and FFE. Conclusions: Preoperative carbohydrate drinks containing potassium may have significantly reduced the incidence of preoperative hypokalemia and improved preoperative thirst and hunger, but did not improve postoperative well-being. However, as part of the enhanced recovery after surgery protocol, preoperative carbohydrate drinks containing potassium should be recommended, as early as first admittance to hospital. Trial registration: The study was registered with the Chinese Clinical Trial Registry at www.chictr.org on February 7, 2017 (registration number: ChiCTR-IOR-17010561).

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“…Previous studies have shown that preoperative oral consumption of clear carbohydrate-rich fluids may attenuate insulin resistance and improve postoperative hunger, thirst, and fatigue as compared to conventional fasting. 27,40 Meanwhile, the risk of PONV has not been shown to increase with oral carbohydrate loading. 12 The results of this study support the efficacy and safety of a shortened fasting duration and oral carbohydrate loading 2 hours prior to surgery in patients undergoing elective craniotomy.…”

Section: Preoperative Management and Evaluation In The Eras Protocolmentioning

confidence: 99%

Safety and efficacy of a novel neurosurgical enhanced recovery after surgery protocol for elective craniotomy: a prospective randomized controlled trial

Wang¹,

Liu²,

Zhao³

et al. 2019

Journal of Neurosurgery

115

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OBJECTIVEAlthough enhanced recovery after surgery (ERAS) programs have gained acceptance in various surgical specialties, no established neurosurgical ERAS protocol for patients undergoing elective craniotomy has been reported in the literature. Here, the authors describe the design, implementation, safety, and efficacy of a novel neurosurgical ERAS protocol for elective craniotomy in a tertiary care medical center located in China.METHODSA multidisciplinary neurosurgical ERAS protocol for elective craniotomy was developed based on the best available evidence. A total of 140 patients undergoing elective craniotomy between October 2016 and May 2017 were enrolled in a randomized clinical trial comparing this novel protocol to conventional neurosurgical perioperative management. The primary endpoint of this study was the postoperative hospital length of stay (LOS). Postoperative morbidity, perioperative complications, postoperative pain scores, postoperative nausea and vomiting, duration of urinary catheterization, time to first solid meal, and patient satisfaction were secondary endpoints.RESULTSThe median postoperative hospital LOS (4 days) was significantly shorter with the incorporation of the ERAS protocol than that with conventional perioperative management (7 days, p < 0.0001). No 30-day readmission or reoperation occurred in either group. More patients in the ERAS group reported mild pain (visual analog scale score 1–3) on postoperative day 1 than those in the control group (79% vs. 33%, OR 7.49, 95% CI 3.51–15.99, p < 0.0001). Similarly, more patients in the ERAS group had a shortened duration of pain (1–2 days; 53% vs. 17%, OR 0.64, 95% CI 0.29–1.37, p = 0.0001). The urinary catheter was removed within 6 hours after surgery in 74% patients in the ERAS group (OR 400.1, 95% CI 23.56–6796, p < 0.0001). The time to first oral liquid intake was a median of 8 hours in the ERAS group compared to 11 hours in the control group (p < 0.0001), and solid food intake occurred at a median of 24 hours in the ERAS group compared to 72 hours in the control group (p < 0.0001).CONCLUSIONSThis multidisciplinary, evidence-based, neurosurgical ERAS protocol for elective craniotomy appears to have significant benefits over conventional perioperative management. Implementation of ERAS is associated with a significant reduction in the postoperative hospital stay and an acceleration in recovery, without increasing complication rates related to elective craniotomy. Further evaluation of this protocol in large multicenter studies is warranted.Clinical trial registration no.: ChiCTR-INR-16009662 (chictr.org.cn)

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Effects of oral carbohydrate with amino acid solution on the metabolic status of patients in the preoperative period: a randomized, prospective clinical trial

Cited by 20 publications

References 37 publications

Effects of preoperative oral carbohydrate electrolyte drinks on preoperative hypokalemia incidence in patients scheduled for laparoscopic colorectal resection: a randomized clinical trial

Effects of preoperative oral carbohydrate electrolyte drinks on preoperative hypokalemia incidence in patients scheduled for laparoscopic colorectal resection: a randomized clinical trial

Effects of Preoperative Oral Carbohydrate Electrolyte Drinks on Preoperative Hypokalemia Incidence in Patients Scheduled for Laparoscopic Colorectal Resection: A Randomized Clinical Trial

Safety and efficacy of a novel neurosurgical enhanced recovery after surgery protocol for elective craniotomy: a prospective randomized controlled trial

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