The role of carbohydrate - rich drink on perioperative discomfort, hemodynamic changes, and insulin responses in spinal anesthesia patients

Abstract

BACKGROUND:The aim of this study was to investigate the role of carbohydrate-rich drink (CHO) on perioperative discomfort, hemodynamic changes, and insulin response in patients undergoing surgery with spinal anesthesia.METHODS:Forty-four adult patients were assigned to one of the two groups of 22, namely preparation with CHO (CHO group) or fasting from midnight (control group). Ten different discomfort variables, blood glucose and insulin concentrations, and hemodynamic changes were recorded during the perioperative period.RESULTS:Preparation with CHO was effective in reducing hunger, thirst, malaise, unfitness, and, to some extent, anxiety (p < 0.05). Plasma glucose and insulin concentrations were increased in the CHO group (p < 0.05). Plasma glucose increased and insulin decreased in the control group (p < 0.05). In the control group, mean arterial pressure was lower compared to the CHO group (p < 0.05).CONCLUSIONS:Preparation with CHO before spinal anesthesia is advantageous due to reducing perioperative discomfort, improving insulin response and stabilizing mean arterial pressure.

Are carbohydrate drinks more effective than preoperative fasting: A systematic review of randomised controlled trials

“…Levels two and three represent those with mild or severe systemic disease. Of the studies assessed, eleven included patients with an ASA grade of I‐II (Bisgaard et al, ; Faria et al, ; Hausel et al, ; Hausel, Nygren, Thorell, Lagerkranser, & Ljungqvist, ; Kaška et al, ; Noblett et al, ; Pexe‐Machado, Oliveira, Dock‐Nascimento, & Aguilar‐Nascimento, ; Sada et al, ; Yagmurdur, Gunal, Yildiz, Gulec, & Topkaya, ; Yildiz, Gunal, Yilmaz, & Yucel, ; Yilmaz et al, ), five studies included patients with ASA grade of I‐III (Mathur et al, ; Pędziwiatr et al, ; Savluk et al, ; Wang, Wang, Wang, & Qin, ; Yang, Yan‐Bing, Xue‐Long, Dong, & Zhi‐Hao, ), and six trials did not state the patients’ ASA grade (Järvelä, Maaranen, & Sisto, ; Lidder et al, ; Rapp‐Kesek, Stridsberg, Andersson, Berne, & Karlsson, ; Singh et al, ; Webster et al, ; Yuill, Richardson, Davidson, Garden, & Parks, ).…”

“…The 22 trials included in this review were conducted across 13 different countries: four in Turkey (Savluk et al, ; Yagmurdur et al, ; Yildiz et al, ; Yilmaz et al, ), two in Brazil (Faria et al, ; Pexe‐Machado et al, ), three in the UK (Lidder et al, ; Noblett et al, ; Yuill et al, ), three in Sweden (Hausel et al, ; Hausel et al, ; Rapp‐Kesek et al, ), two in China (Wang et al, ; Yang et al, ) and one each in Poland (Pędziwiatr et al, ), Australia (Webster et al, ), Denmark (Bisgaard et al, ), New Zealand (Mathur et al, ), Kosovo/Serbia (Sada et al, ), Czech republic (Kaška et al, ), India (Singh et al, ) and Finland (Järvelä et al, ).…”

“…From the nineteen abdominal surgery‐based trials, seven included those having a laparoscopic cholecystectomy (Bisgaard et al, ; Faria et al, ; Hausel et al, ; Pędziwiatr et al, ; Singh et al, ; Yildiz et al, ; Yilmaz et al, ), while five focused on colorectal surgery (Kaška et al, ; Lidder et al, ; Noblett et al, ; Wang et al, ; Webster et al, ). Of the remaining papers, one each focused on patients undergoing gastrointestinal resections (Pexe‐Machado et al, ), radical distal gastrectomy (Yang et al, ), inguinal hernia repair (Yagmurdur et al, ) and liver resections (Mathur et al, ). One study included patients having colorectal surgery and laparoscopic cholecystectomy (Hausel et al, ).…”

“…Six trials involving 422 patients compared the effect of carbohydrate drinks on postoperative discomfort. In one trial, there was a significant reduction in nausea in the carbohydrate group (Yilmaz et al, ), while there was a slight reduction in the feelings of nausea in three trials (Savluk et al, ; Yagmurdur et al, ; Yildiz et al, ). However, one trial reported increased episodes of nausea in the carbohydrate group as opposed to the preoperative fasting group (Järvelä et al, ).…”

“…Three trials compared the effect of carbohydrate drinks with preoperative fasting on hunger, thirst or dry mouth with significant improvements related to each of the three outcomes amongst the carbohydrate group (Savluk et al, ; Yagmurdur et al, ; Yildiz et al, ). Two trials compared the effect of carbohydrate drinks on weakness or malaise with both trials reporting significant improvement amongst the carbohydrate group (Yagmurdur et al, ; Yildiz et al, ).…”