A preoperative carbonated beverage appears to decrease hunger and nausea after surgery, according to a study presented here at the 2018 Annual Meeting of the American Society of Anesthesiologists (ASA).
Surgical stress combined with fasting tends to worsen the catabolic state, cause insulin resistance, and potentially delay recovery, noted Ramon E. Abola, MD, Stony Brook Medical Center, Stony Brook, New York, and colleagues.
Researchers have started investigating the use of carbohydrate-rich beverages to help lighten these effects. One systematic review conducted in 2011 found that administration of oral carbohydrate drinks before surgery is likely to be safe and may have a positive influence on a wide range of perioperative markers of clinical outcome.
Investigators also know that normal glucose levels after surgery are associated with fewer adverse outcomes, and that patients report less thirst and anxiety if they consume clear liquids up to 2 hours before surgery.
For the current study, Dr. Abola and colleagues evaluated the impact of a preoperative carbohydrate beverage on patient well-being within the context of an enhanced recovery after surgery (ERAS) program for minimally invasive gynaecological surgery. They included 102 ambulatory patients undergoing laparoscopic or robotic hysterectomy, myomectomy, or adnexal surgery for benign conditions.
All patients were given maltodextrin powder packets (Nutricia Preop) during the preoperative anaesthesia clinic visit and instructed to drink 2 packets with water the night before surgery, then again 2 packets with water the day of surgery prior to leaving for home. The pre (n = 49) and post (n = 51) ERAS groups were comparable in age, weight, race, medical comorbidities, surgery type, and type of surgery.
While hunger was significantly lower and nausea marginally lower in the post-ERAS group on the morning of surgery, there were no differences in the degree of thirst, headache, or lightheadedness between the 2 groups.
The median time between last drink and surgery start was similar between the 2 groups (pre-ERAS 9.7 hours, post ERAS, 8.8 hours). Of the 34 patients who drank the carbohydrate beverage, 82% were able to complete the drink and 26% reported nausea immediately after completing the drink.
“Continued efforts are needed to encourage patients to continue drinking fluids closer to surgery start time,” the authors concluded.
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