Issn Print: 0265-0215

Publication Date: 2007/06/01


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The role of carbohydrate - rich drink on perioperative discomfort, hemodynamic changes, and insulin responses in spinal anesthesia patients: 8AP4-4

H. Yagmurdur; S. Gunal; H. Yildiz; H. Gulec; C. Topkaya

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Background and Goal of Study: The fasting period before elective surgery is often long enough to deplete carbohydrate reserves and also uncomfortable for the patient(1). The aim of this study was to investigate the role of carbohydrate-rich drink on perioperative discomfort, haemodynamic changes, and insulin response in elective lower abdominal surgery patients with spinal anaesthesia.
Materials and Methods: Fourty-four consecutive ASA I-II adult patients were randomly assigned to one of two groups: preparation with carbohy-drate-rich drink (CHO = 22 patients) or fasting from midnight (Fasted = 22 patients). During the evening before surgery, patients in the CHO group ingested 800 mL of carbohydrate-rich drink. Also another 400 mL of morning drink at least 90 min before spinal anaesthesia was allowed in the CHO group. The patients in the Fasted group underwent spinal anaesthesia after the routine fast from midnight. Visual analogue scales were used to score 10 different discomfort variables. Also blood glucose and insulin concentrations and haemodynamic changes were recorded during perioperative period.
Results and Discussion: The visual analogue scale scores in a control situation and before intake of morning drink not different between groups. The CHO group was less hungry, less thirsty and experienced less malaise and unfitness during the period before and after the spinal anaesthesia (p < 0.05). Also the CHO group was less anxious than the Fasted group before spinal anaesthesia (p < 0.05). Trend analysis showed decreasing hunger, thirst, malaise, and unfitness during perioperative period and decreasing anxiety during the waiting period before surgery (p < 0.05). In the Fasted group, hunger and thirst increased during perioperative period (p < 0.05). Plasma glucose and insulin concentrations were increased in the CHO group before spinal anaesthesia (p < 0.05). Plasma glucose increased and insulin decreased in the Fasted group at 60 min after the spinal anaesthesia (p < 0.05). In the Fasted group, mean arterial pressure was lower at before and 10 and 20 min after the spinal anaesthesia compared to the CHO group (p < 0.05).
Conclusion: Preparation with oral carbohydrate before spinal anaesthesia had advantages over overnight fasting by reducing perioperative discomfort, improving insulin response and stabilizing mean arterial pressure in lower abdominal surgery patients(2).

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