Detailed Abstract
[BP Oral Presentation 4 - Biliary Disease/Surgery]
[BP OP 4-6] Effects of preoperative oral carbohydrates on quality of recovery in laparoscopic cholecystectomy : A randomized, double blind, placebo controlled trial
Joon Seong PARK1, Jeong Soo LEE2, Young SONG2, Ji Young KIM2, Dong Sup YOON1
1Department of Surgery, Pancreatobiliary Cancer Clinic, Gangnam Severance Hospital, Yonsei University College of Medicine, Korea
2Department of Anesthesiology and Pain Medicine, Anesthesia and Pain Research, Yonsei University College of Medicine, Korea, Korea
Introduction : While carbohydrate loading is an important component of enhanced patient recovery after surgery, no study has evaluated the effects of preoperative carbohydrate loading after laparoscopic cholecystectomy on patient satisfaction and overall recovery. Thus, we aimed to investigate the impact of preoperative oral carbohydrates on the quality of patient recovery after laparoscopic cholecystectomy
Methods : A total of 153 adult patients who underwent laparoscopic cholecystectomy were randomized into three study groups. Patients in group MN-NPO were fasted from midnight until surgery. Patients in group No-NPO received 400 mL of a clear carbohydrate beverage on the evening before surgery, and a morning dose of 400 mL was ingested at least 2 hours before surgery . Patients in group Placebo received the same quantity of flavored water at the same times as for group No-NPO. The quality of recovery was evaluated pre and postoperatively using the QoR-40 questionnaire. Intraoperative hemodynamic changes were also evaluated.
Results : There were no significant differences among the groups in terms of the pre- and postoperative global QoR-40 scores (P = 0.25). Group MN-NPO had an elevated heart rate compared to patients who ingested a preoperative beverage (groups No-NPO and Placebo; P = 0.041).
Conclusions : The preoperative carbohydrate beverage did not improve quality of recovery using the QoR-40 compared to placebo or conventional fasting. However, the preoperative fasting group had a consistently increased heart rate during changes in body position that induced hypotension which is likely a result of depletion of effective intravascular volume caused by traditional fasting over 8 hours.
Methods : A total of 153 adult patients who underwent laparoscopic cholecystectomy were randomized into three study groups. Patients in group MN-NPO were fasted from midnight until surgery. Patients in group No-NPO received 400 mL of a clear carbohydrate beverage on the evening before surgery, and a morning dose of 400 mL was ingested at least 2 hours before surgery . Patients in group Placebo received the same quantity of flavored water at the same times as for group No-NPO. The quality of recovery was evaluated pre and postoperatively using the QoR-40 questionnaire. Intraoperative hemodynamic changes were also evaluated.
Results : There were no significant differences among the groups in terms of the pre- and postoperative global QoR-40 scores (P = 0.25). Group MN-NPO had an elevated heart rate compared to patients who ingested a preoperative beverage (groups No-NPO and Placebo; P = 0.041).
Conclusions : The preoperative carbohydrate beverage did not improve quality of recovery using the QoR-40 compared to placebo or conventional fasting. However, the preoperative fasting group had a consistently increased heart rate during changes in body position that induced hypotension which is likely a result of depletion of effective intravascular volume caused by traditional fasting over 8 hours.
SESSION
BP Oral Presentation 4
Room C 3/31/2018 9:20 AM - 10:10 AM