Effects of preoperative oral carbohydrate solution intake on Patients’ anxiety

Despite being a routine practice, preoperative fasting was shown not to decrease the amount and acidity of gastric content. In fact, excessive hunger is associated with adverse outcomes and delayed recovery. Research demonstrating such efficacy of preoperative oral carbohydrates still remains controversial. In this study, we aimed to evaluate the effects of preoperative oral carbohydrate solution (OCS) intake on preoperative and postoperative anxiety levels of surgical patients. Sixty patients who would undergo surgical intervention with ASA I score were included to the study. Patients were randomized to receive either 400 ml OCS (Group I, n=30) or 400 ml water (Group II, n=30) each at the last night and two hours before surgery. Three groups of anxiety tests, including the State-Trait Anxiety Inventory (STAI), the Amsterdam Preoperative Anxiety and Information Scale (APAIS), and Visual Analog Scale for Anxiety (VAS-A), were performed at the night and two hours before and six hours after the operation. At t1, the mean VAS-A was significantly lower in Group I (43.2±20.9) compared to that in Group II (59.7±24.1; p=0.01). STAI at t1 was also significantly lower in Group I than that in Group II (44.7±12.6 and 51.9±13.0, respectively; p=0.032). The scores in the other time-points (t0 and t2) were found as similar. APAIS scores did not differ between the groups. Preoperative OSC intake seems to have a tendency of reducing anxiety in operated cancer patients.

___

1. Ljungqvist O, Soreide E. Preoperative fasting. Br J Surg. 2003;90:400-6.

2. Lambert E, Carey S. Practice Guideline Recommendations on Perioperative Fasting: A Systematic Review. JPEN J Parenter Enteral Nutr. 2016;40:1158-65.

3. Practice Guidelines for Preoperative Fasting and the Use of Pharmacologic Agents to Reduce the Risk of Pulmonary Aspiration: Application to Healthy Patients Undergoing Elective Procedures: An Updated Report by the American Society of Anesthesiologists Task Force on Preoperative Fasting and the Use of Pharmacologic Agents to Reduce the Risk of Pulmonary Aspiration. Anesthesiology. 2017;126:376-93.

4. Noblett SE, Watson DS, Huong H, et al. Pre-operative oral carbohydrate loading in colorectal surgery: a randomized controlled trial. Colorectal Dis. 2006;8:563-9.

5. Botella-Carretero JI, Iglesias B, Balsa JA, et al. Perioperative oral nutritional supplements in normally or mildly undernourished geriatric patients submitted to surgery for hip fracture: a randomized clinical trial. Clin Nutr. 2010;29:574-9.

6. de Aguilar-Nascimento JE, de Almeida Dias AL, Dock-Nascimento DB, et al. Actual preoperative fasting time in Brazilian hospitals: the BIGFAST multicenter study. Ther Clin Risk Manag. 2014;10:107-12.

7. Soreide E, Ljungqvist O. Modern preoperative fasting guidelines: a summary of the present recommendations and remaining questions. Best Pract Res Clin Anaesthesiol. 2006;20:483-91.

8. Hausel J, Nygren J, Lagerkranser M, et al. A carbohydrate-rich drink reduces preoperative discomfort in elective surgery patients. Anesth Analg. 2001;93:1344-50.

9. Mathur S, Plank LD, McCall JL, et al. Randomized controlled trial of preoperative oral carbohydrate treatment in major abdominal surgery. B J Surg. 2010;97:485-94.

10. Jarvela K, Maaranen P, Sisto T. Pre-operative oral carbohydrate treatment before coronary artery bypass surgery. Acta Anaesthesiol Scand. 2008;52:793-7.

11. Yuill KA, Richardson RA, Davidson HI, et al. The administration of an oral carbohydrate-containing fluid prior to major elective upper-gastrointestinal surgery preserves skeletal muscle mass postoperatively--a randomised clinical trial. Clin Nutr. 2005;24:32-7.

12. Spielberg C, Gorsuch R, Lushene R, et al. Manual for the state-trait anxiety inventory. Palo Alto. CA: Consulting psychologists press, 1970.

13. Moerman N, van Dam FS, Muller MJ, et al. The Amsterdam Preoperative Anxiety and Information Scale (APAIS). Anesth Analg. 1996;82:445-51.

14. Pimenta GP, de Aguilar-Nascimento JE. Prolonged preoperative fasting in elective surgical patients: why should we reduce it? Nutr Clin Pract. 2014;29:22-8

15. Falconer R, Skouras C, Carter T, et al. Preoperative fasting: current practice and areas for improvement. Updates Surg. 2014;66:31-9.

16. Smith I, Kranke P, Murat I, et al. Perioperative fasting in adults and children: guidelines from the European Society of Anaesthesiology. Eur J Anaesthesiol. 2011;28:556-69.

17. Jankowski CJ. Preparing the Patient for Enhanced Recovery After Surgery. Int Anesthesiol Clin. 2017;55:12-20.

18. Helminen H, Viitanen H and Sajanti J. Effect of preoperative intravenous carbohydrate loading on preoperative discomfort in elective surgery patients. Eur J Anaesthesiol. 2009;26:123-7.

19. Can MF, Yagci G, Dag B, et al. Preoperative administration of oral carbohydrate-rich solutions: Comparison of glucometabolic responses and tolerability between patients with and without insulin resistance. Nutrition. 2009;25:72-7.

20. Bilku DK, Dennison AR, Hall TC, et al. Role of preoperative carbohydrate loading: a systematic review. Ann R Coll Surg Engl. 2014;96:15-22.

21. Yilmaz N, Cekmen N, Bilgin F, et al. A. Preoperative carbohydrate nutrition reduces postoperative nausea and vomiting compared to preoperative fasting. J Res Med Sci. 2013;18:827-32.

22. Ganry L, Hersant B, Sidahmed-Mezi M, et al. Using virtual reality to control preoperative anxiety in ambulatory surgery patients: A pilot study in maxillofacial and plastic surgery. J Stomatol Oral Maxillofac Surg. 2018;119:257-61.

23. Aust H, Eberhart L, Sturm T, et al. A cross-sectional study on preoperative anxiety in adults. J Psychosom Res. 2018;111:133-9.

24. Çetinkaya F, Kavuran E, Ünal Aslan KS.Validity and reliability of the Amsterdam Preoperative Anxiety and Information Scale in the Turkish population. Turk J Med Sci. 2019;49:178-83.

25. Sada F, Krasniqi A, Hamza A, et al. A randomized trial of preoperative oral carbohydrates in abdominal surgery. BMC anesthesiol. 2014;14:93.

26. Tsutsumi R, Kakuta N, Kadota T, et al. Effects of oral carbohydrate with amino acid solution on the metabolic status of patients in the preoperative period: a randomized, prospective clinical trial. J Anesth. 2016;30:842-9.

27. Bisgaard T, Kristiansen VB, Hjortso NC, et al. Randomized clinical trial comparing an oral carbohydrate beverage with placebo before laparoscopic cholecystectomy. Br J Surg. 2004;91:151-8.
Medicine Science-Cover
  • ISSN: 2147-0634
  • Yayın Aralığı: Yılda 4 Sayı
  • Başlangıç: 2012
  • Yayıncı: Effect Publishing Agency ( EPA )