Weiwei Jiang1, Xiang Liu2, Fengli Liu3, Shungen Huang4, Jie Yuan5, Yingzuo Shi6, Huan Chen1, Jie Zhang1, Changgui Lu1, Wei Li1, Qiming Geng1, Xiaoqun Xu1, Weibing Tang7. 1. Department of Pediatric Surgery, Children's Hospital of Nanjing Medical University, Nanjing, China. 2. Anhui Provincial Children's Hospital, Hefei, China. 3. Xuzhou Children's Hospital, Xuzhou, China. 4. Children's Hospital of Soochow University, Suzhou, China. 5. Changzhou Children's Hospital, Changzhou, China. 6. Wuxi Children's Hospital, Wuxi, China. 7. Department of Pediatric Surgery, Children's Hospital of Nanjing Medical University, Nanjing, China. tangweibingcn@163.com; 68824153@qq.com.
Abstract
BACKGROUND AND OBJECTIVES: Pre-operative oral carbohydrate administration (POCA) is an important aspect of enhanced recovery after surgery and has many advantages. The objective of this study was to explore the safety and effect of pre-operative oral carbohydrate administration in infants. METHODS AND STUDY DESIGN: This was a prospective, multi-center, randomized study that randomly assigned 1200 infants into four groups. In the control group (group A), the infants were strictly restricted to 6-h preoperative fasting before anesthesia. In the enhanced recovery after surgery (ERAS) groups (groups B, C, and D), the infants were orally administered a 10% carbohydrate solution (10% glucose water; 5, 10, and 15 mL/kg, respectively) 2 h before anesthesia. Blood glucose, gastric residual volumes, crying ratios, and the length of hospital stay were observed. RESULTS: The blood glucose was significantly higher in groups B, C, and D than group A at the time of anesthesia. The gastric residual volume revealed virtually no residue in groups A, B, and C, but 15 infants in group D had a gastric residual volume. The crying ratio was significantly higher in group A. The length of hospital stay was not significantly different between the groups. CONCLUSIONS:POCA is well-tolerated in infants at a dose of 10 mL/kg.
RCT Entities:
BACKGROUND AND OBJECTIVES: Pre-operative oral carbohydrate administration (POCA) is an important aspect of enhanced recovery after surgery and has many advantages. The objective of this study was to explore the safety and effect of pre-operative oral carbohydrate administration in infants. METHODS AND STUDY DESIGN: This was a prospective, multi-center, randomized study that randomly assigned 1200 infants into four groups. In the control group (group A), the infants were strictly restricted to 6-h preoperative fasting before anesthesia. In the enhanced recovery after surgery (ERAS) groups (groups B, C, and D), the infants were orally administered a 10% carbohydrate solution (10% glucosewater; 5, 10, and 15 mL/kg, respectively) 2 h before anesthesia. Blood glucose, gastric residual volumes, crying ratios, and the length of hospital stay were observed. RESULTS: The blood glucose was significantly higher in groups B, C, and D than group A at the time of anesthesia. The gastric residual volume revealed virtually no residue in groups A, B, and C, but 15 infants in group D had a gastric residual volume. The crying ratio was significantly higher in group A. The length of hospital stay was not significantly different between the groups. CONCLUSIONS: POCA is well-tolerated in infants at a dose of 10 mL/kg.
Authors: Adriana S Gandolfo; Priscilla F N Cardoso; Izabel M Buscatti; Manoel Carlos P Velhote; Maria Aparecida C Bonfim; Alberto C Helito Journal: Clinics (Sao Paulo) Date: 2021-08-04 Impact factor: 2.365