Abstract
Background & Aims:
Nutritional and metabolic preparation of the body facilitates mitigation of increased catabolism, insulin resistance and therby attenuates the stress responses to surgery. . Nutritional and metabolic preparation of the body facilitates in mitigation of increased catabolism, insulin resistance and thus stress response to surgery. The present study therefore aimed at evaluating the effects of preoperative oral glucose loading and its effects in decreasing the stress response to surgery.
Methods:
The present study included Forty adult patients scheduled for elective surgery under general anesthesia who were then randomly allocated into two groups of 20 patients each. Patients in group G received glucose orally on the evening before surgery (100g) and on the morning of surgery (50g). Patients in group N did not receive glucose. All patients of both groups followed standard American Society of Anaesthesiologists ( ASA) fasting guidelines. Assessment for blood glucose, cortisol and interleukin-6 along with patient well-being were made at different time intervals.
Results:
The magnitude of increase in the Serum Cortisol from the baseline was significantly more in group-N as compared to group-G. The increase in the blood glucose levels was significantly less in group-G at T24. The magnitude of increase in the interleukin-6 levels from the baseline was significant at T24 in both the groups. Also significant number of patients in group-N experienced thirst, hunger and anxiety. Patients in group-G experienced less intense pain when compared to group-N.
Conclusion:
I Preoperative oral glucose loading was associated with significant reduction in the stress-response to surgery because of the concomitant decrease in the magnitudeof increase in blood-glucose and serum-cortisol levels.Also enhanced a patient well-being postoperatively in the form of reduced pain and anxiety was the additional Benefit of preoperatively glucose loading.
| Group N | Group G | P | |||
|---|---|---|---|---|---|
|
|
|
||||
| Mean±SD | Median (IQR) | Mean±SD | Median (IQR) | ||
| Cortisol (T0) | 202.22±289.89 | 74.435 (23.46-267.95) | 279.63±258.67 | 180.60 (92.65-355.81) | 0.028 |
| Cortisol (T1) | 596.46±536.15 | 388.30 (202.94-1074.18) | 384.42±385.52 | 231.50 (141.83-510.60) | 0.164 |
| Cortisol (T6) | 555.38±501.41 | 280.43 (164.48-946.80) | 373.55±295.83 | 234.30 (131.42-642.55) | 0.234 |
| Cortisol (T24) | 329.32±339.68 | 137.7 (107.07-573.80) | 193.06±213.48 | 113.70 (88.00-203.93) | 0.204 |
KEYWORDS: Oral glucose, stress response, surgery, General anaesthesia
References
- 1.Leiper JB. Fate of ingested fluids:factors affecting gastric emptying and intestinal absorption of beverages in humans. Nutrition Reviews. 2015 Sep;:57–72. doi: 10.1093/nutrit/nuv032. d1;73(suppl_2) [DOI] [PubMed] [Google Scholar]
- 2.Widnyana IM, Senapathi TG, Aryabiantara IW, Wiryana M, Sinardja K, Budiarta IG. Metabolic stress response attenuate by oral glucose preoperatively in patient underwent major surgery with general anesthesia. Int J Anesth Pain Med. 2017;3:1. [Google Scholar]