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Effects of Preoperative Oral Carbohydrates on Quality of Recovery in Laparoscopic Cholecystectomy: A Randomized, Double Blind, Placebo-Controlled Trial

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Abstract

Background

While carbohydrate loading is an important component of enhanced patient recovery after surgery, no study has evaluated the effects of preoperative carbohydrate loading after laparoscopic cholecystectomy (LC) on patient satisfaction and overall recovery. Thus, we aimed to investigate the impact of preoperative oral carbohydrates on scores from the quality of recovery 40-item (QoR-40) questionnaire after LC.

Methods

A total of 153 adults who underwent LC were randomized into three groups. Group MN-NPO was fasted from midnight until surgery. Group No-NPO received 400 mL of a carbohydrate beverage on the evening before surgery, and a morning dose of 400 mL was ingested at least 2 h before surgery. Group Placebo received the same quantity of flavored water as for group No-NPO. The quality of recovery after general anesthesia was evaluated using QoR-40 questionnaire. Intraoperative hemodynamics were also evaluated.

Results

There were no significant differences among the groups in terms of the pre- and postoperative global QoR-40 scores (P = 0.257). Group MN-NPO had an elevated heart rate compared to patients who ingested a preoperative beverage (groups No-NPO and Placebo; P = 0.0412).

Conclusions

The preoperative carbohydrate beverage did not improve quality of recovery using the QoR-40 questionnaire after general anesthesia for laparoscopic cholecystectomy compared to placebo or conventional fasting. However, the preoperative fasting group had a consistently increased heart rate during changes in body position that induced hypotension, which is likely a result of depletion of effective intravascular volume caused by traditional fasting over 8 h.

Trial Registration

Clinical trial.gov identifier: NCT02555020.

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Acknowledgement

Nos-NPO® and Placebo beverages were provided by the Daesang Corporation, Korea.

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Authors and Affiliations

  1. Department of Anesthesiology and Pain Medicine, Anesthesia and Pain Research Institute, Severance Cancer Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea

    Jeong Soo Lee

  2. Department of Anesthesiology and Pain Medicine, Anesthesia and Pain Research Institute, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea

    Young Song & Ji Young Kim

  3. Pancreatobiliary Cancer Clinic, Department of Surgery, Gangnam Severance Hospital, Yonsei University College of Medicine, 211 Eonju-ro, Gangnam-gu, Seoul, 06273, Republic of Korea

    Joon Seong Park & Dong Sup Yoon

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  1. Jeong Soo Lee
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  2. Young Song
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Correspondence to Joon Seong Park.

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Lee, J.S., Song, Y., Kim, J.Y. et al. Effects of Preoperative Oral Carbohydrates on Quality of Recovery in Laparoscopic Cholecystectomy: A Randomized, Double Blind, Placebo-Controlled Trial. World J Surg 42, 3150–3157 (2018). https://doi.org/10.1007/s00268-018-4717-4

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  • DOI: https://doi.org/10.1007/s00268-018-4717-4

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