A Karlsson1, K Wendel1, S Polits1, H Gislason1, J L Hedenbro2,3. 1. Aleris Obesity Academy, Sweden and Norway, St Lars v 45B, SE 222 70, Lund, Sweden. 2. Aleris Obesity Academy, Sweden and Norway, St Lars v 45B, SE 222 70, Lund, Sweden. Jan.Hedenbro@med.lu.se. 3. Department of Surgery, Clinical Sciences, Lund University, Lund, Sweden. Jan.Hedenbro@med.lu.se.
Abstract
BACKGROUND: Many patients experience postoperative nausea and vomiting (PONV). Preoperative treatment with carbohydrate solutions seems to improve the course after different types of surgery. This study was undertaken to investigate the potential value of different models for preoperative hydration/nutrition, in addition to our ERAS (enhanced recovery after surgery) protocol. METHODS:Ninety non-diabetic women planned for elective laparoscopic gastric bypass and aged 18-65 years were included. All were on preoperative low-calorie diet (LCD). They were randomized into three arms, either a carbohydrate-rich drink, a protein-enriched drink, or tap water and instructed to drink 800 and 200 mL 16 and 2 h, respectively, prior to operation. Risk factors for PONV were recorded preoperatively. All patients were operated before lunch and received 1500-2000 mL of Ringer-Acetate solution during the 24-30-h postoperative hospital time. Four variables (nausea, pain, tiredness, and headache) were registered on 100-mm visual analog scales six times over 22 h. The need for additional medication was registered. RESULTS: Out of 90 patients, 73 complete datasets were obtained. Nausea peaked at 7 p.m. but with no statistically significant differences between groups for any of the variables. Pain peaked the first 2 h postoperatively, remained longer, and had not returned to baseline values at 6 a.m. the morning after surgery but with no difference between groups. CONCLUSIONS: Inside our ERAS protocol, additional preoperative carbohydrate- or protein-enriched fluid treatment did not further reduce immediate patient discomfort in laparoscopic gastric bypass surgery.
RCT Entities:
BACKGROUND: Many patients experience postoperative nausea and vomiting (PONV). Preoperative treatment with carbohydrate solutions seems to improve the course after different types of surgery. This study was undertaken to investigate the potential value of different models for preoperative hydration/nutrition, in addition to our ERAS (enhanced recovery after surgery) protocol. METHODS: Ninety non-diabeticwomen planned for elective laparoscopic gastric bypass and aged 18-65 years were included. All were on preoperative low-calorie diet (LCD). They were randomized into three arms, either a carbohydrate-rich drink, a protein-enriched drink, or tapwater and instructed to drink 800 and 200 mL 16 and 2 h, respectively, prior to operation. Risk factors for PONV were recorded preoperatively. All patients were operated before lunch and received 1500-2000 mL of Ringer-Acetate solution during the 24-30-h postoperative hospital time. Four variables (nausea, pain, tiredness, and headache) were registered on 100-mm visual analog scales six times over 22 h. The need for additional medication was registered. RESULTS: Out of 90 patients, 73 complete datasets were obtained. Nausea peaked at 7 p.m. but with no statistically significant differences between groups for any of the variables. Pain peaked the first 2 h postoperatively, remained longer, and had not returned to baseline values at 6 a.m. the morning after surgery but with no difference between groups. CONCLUSIONS: Inside our ERAS protocol, additional preoperative carbohydrate- or protein-enriched fluid treatment did not further reduce immediate patient discomfort in laparoscopic gastric bypass surgery.
Entities:
Keywords:
Carbohydrates; Gastric bypass; Nausea; Pain; Preoperative nutrition; Protein
Authors: C C Apfel; F M Heidrich; S Jukar-Rao; L Jalota; C Hornuss; R P Whelan; K Zhang; O S Cakmakkaya Journal: Br J Anaesth Date: 2012-10-03 Impact factor: 9.166
Authors: Bart Torensma; Chris H Martini; Martijn Boon; Erik Olofsen; Bas In 't Veld; Ronald S L Liem; Mireille T T Knook; Dingeman J Swank; Albert Dahan Journal: PLoS One Date: 2016-12-09 Impact factor: 3.240
Authors: Erik Stenberg; Luiz Fernando Dos Reis Falcão; Mary O'Kane; Ronald Liem; Dimitri J Pournaras; Paulina Salminen; Richard D Urman; Anupama Wadhwa; Ulf O Gustafsson; Anders Thorell Journal: World J Surg Date: 2022-01-04 Impact factor: 3.352