Does Preoperative Carbohydrate Intake Reduces Postoperative Stress Response in Patients Undergoing Valve Replacement Surgeries
Journal Title: Enliven: Journal of Anesthesiology and Critical Care Medicine - Year 2015, Vol 2, Issue 1
Abstract
Background Cardiac surgery is a stress that causes insulin resistance leading to increased insulin requirements. The aim of our study was to evaluate whether preoperative oral intake of carbohydrate rich drinks could improve outcomes and reduce stress response post valve replacement cardiac surgeries. Methods Our prospective study included 20 ASA 1-3 patients undergoing valve replacement cardiac surgeries.10 patients were fasted after midnight while the other 10 patients received 600 ml of carbohydrate bevering in the evening before the procedure and 150 ml of the drink 2 hours before operation. The following was monitored in all patients: hemodynamics after induction of anesthesia till 24 hours postoperative, insulin resistance (exogenous insulin requirement to keep blood sugar below or equal to 10 mmol/l was used as marker), postoperative discomfort using visual analogue scales, and length of ICU stay. Results Preoperative intake of carbohydrate rich drinks significantly reduced the length of ICU stay (p=0.019) due to reduced postoperative inotropic support requirements and time of mechanical ventilation. Significant reduction in postoperative discomfort and reduced stress response .No significant difference in postoperative level of insulin sensitivity between the two groups. Conclusion Our study showed that although preoperative carbohydrate intake does not reduce insulin resistance postoperatively, it significantly improved other aspects of clinical outcome, in terms of reduced ICU stay, reduced postoperative stress and patient discomfort.
Authors and Affiliations
Shokri Hoda, Ali Ihab
Keywords
Related Articles
- EP ID EP618634
- DOI -
- Views 164
- Downloads 0
Anaesthetic Management of a Child with Laryngeal Papillomas
The excision of laryngeal papillomas poses a great challenge for both the anesthesiologist and the surgeon. Laser surgery offers several advantages to the surgeon and patient; i.e. microscopic precision, a bloodless oper...
Red Blood Cell Distribution Width and Mortality in ICU Patients; A Cross Sectional Retrospective Analysis Red Blood Cell Distribution Width and Mortality in ICU Patients
Introduction The red blood cell distribution width (RDW) is a predictor of mortality in many conditions. We investigated the prognostic value of RDW in the general ICU population. Methods Two hundred and seventy-four pa...
Sugammadex: Safe for Ambulatory Surgery in Patients with ALS?
Amyotrophic lateral sclerosis (ALS) is an autosomal- dominant disease which characterized by degeneration of upper and lower neurons. Sugammadex, is an agent acts encaplulating steroidal muscular relaxant to form a stabl...
Comparison of the Use of Epidrum with Air or Saline for Identifying the Epidural Space
Background Identification of the epidural space has a critical role in epidural anesthesia. Epidrum® has been a recently developed air operated device used for identifying the epidural space. This study compares the usag...
The Effect of Different Levels of Elevated Artificial Pneumoperitoneum Pressure on the Cerebral Perfusion Pressure During Laparoscopic-Cholycystectomy
Background and Aims With increasing laparoscopic surgeries there is a lot of argument about its techniques as regard method for peritoneal cavity approach by creating pneumoperitoneum using Veress needle which may have m...