TY - JOUR
T1 - Effects of a Preoperative Carbohydrate Load on Postoperative Recovery in Children
T2 - A Randomised, Double-Blind, Placebo-Controlled Trial
AU - Laird, Ashleigh
AU - Bramley, Lynsey
AU - Barnes, Richard
AU - Englin, Anna
AU - Winderlich, Jacinta
AU - Mount, Elizabeth
AU - Nataraja, Ramesh M.
AU - Pacilli, Maurizio
N1 - Funding Information:
We thank the following colleagues from the Department of Anaesthesia at Monash Health for the support provided during the trial: Drs Damian Castanelli, Rachel Chapman, Joanne Ee, Tracy Jackson, Cassandra Lang, Paul McCallum, Sangeetha Murthi, Samuel Sha, Joseph Speekman, and Valerie Taylor. Thank you to the nursing staff in the Post-Anaesthesia Care Unit and the Day Ward, your help was invaluable.
Publisher Copyright:
© 2023 Elsevier Inc.
PY - 2023/9
Y1 - 2023/9
N2 - Background: Nausea and vomiting are common causes for prolonged postoperative length of hospital stay (LOS) in children. A preoperative carbohydrate load may reduce postoperative nausea and vomiting by improving the perioperative metabolic state. The aim of this study was to determine if a preoperative carbohydrate-containing drink would lead to an improvement in the perioperative metabolic state and consequently reduce the incidence of postoperative nausea, vomiting and LOS in children undergoing day-case surgical procedures. Method: Randomised, double-blind, placebo-controlled trial involving children aged 4 to 16-years undergoing day-case surgical procedures. Patients were randomised to receive a carbohydrate-containing drink or a placebo. During the induction of anaesthesia, a venous blood gas, and blood glucose and ketone levels were measured. Postoperatively, the incidence of nausea, vomiting, and LOS were documented. Results: 120 patients were randomised with 119/120 (99.2%) undergoing analysis. Blood glucose level was higher in the carbohydrate group; 5.4 mmol/L [3.3–9.4] versus 4.9 mmol/L [3.6–6.5] (p = 0.01). Blood ketone level was lower in the carbohydrate group; 0.2 mmol/L versus 0.3 mmol/L (p = 0.003). The incidence of nausea and vomiting was not different (p > 0.9 and p = 0.8, respectively). LOS in the carbohydrate group was 26 min shorter than the placebo group (p = 0.02). Conclusion: Although a preoperative carbohydrate load may provide a more stable metabolic state at the induction of anaesthesia, we did not find a reduction in postoperative nausea and vomiting. A preoperative carbohydrate load has also minimal effects on the postoperative LOS. Type of study: Randomised clinical trial. Level of evidence: I.
AB - Background: Nausea and vomiting are common causes for prolonged postoperative length of hospital stay (LOS) in children. A preoperative carbohydrate load may reduce postoperative nausea and vomiting by improving the perioperative metabolic state. The aim of this study was to determine if a preoperative carbohydrate-containing drink would lead to an improvement in the perioperative metabolic state and consequently reduce the incidence of postoperative nausea, vomiting and LOS in children undergoing day-case surgical procedures. Method: Randomised, double-blind, placebo-controlled trial involving children aged 4 to 16-years undergoing day-case surgical procedures. Patients were randomised to receive a carbohydrate-containing drink or a placebo. During the induction of anaesthesia, a venous blood gas, and blood glucose and ketone levels were measured. Postoperatively, the incidence of nausea, vomiting, and LOS were documented. Results: 120 patients were randomised with 119/120 (99.2%) undergoing analysis. Blood glucose level was higher in the carbohydrate group; 5.4 mmol/L [3.3–9.4] versus 4.9 mmol/L [3.6–6.5] (p = 0.01). Blood ketone level was lower in the carbohydrate group; 0.2 mmol/L versus 0.3 mmol/L (p = 0.003). The incidence of nausea and vomiting was not different (p > 0.9 and p = 0.8, respectively). LOS in the carbohydrate group was 26 min shorter than the placebo group (p = 0.02). Conclusion: Although a preoperative carbohydrate load may provide a more stable metabolic state at the induction of anaesthesia, we did not find a reduction in postoperative nausea and vomiting. A preoperative carbohydrate load has also minimal effects on the postoperative LOS. Type of study: Randomised clinical trial. Level of evidence: I.
KW - Carbohydrate load
KW - Children
KW - Length of hospital stay
KW - Perioperative metabolism
KW - Postoperative nausea
KW - Postoperative recovery
UR - http://www.scopus.com/inward/record.url?scp=85160833380&partnerID=8YFLogxK
U2 - 10.1016/j.jpedsurg.2023.05.004
DO - 10.1016/j.jpedsurg.2023.05.004
M3 - Article
AN - SCOPUS:85160833380
SN - 0022-3468
VL - 58
SP - 1824
EP - 1831
JO - Journal of Pediatric Surgery
JF - Journal of Pediatric Surgery
IS - 9
ER -