PDF(Pubmed)
Abstract：
BACKGROUND: Enhanced recovery after surgery advocates that consuming carbohydrates two hours before anesthesia is beneficial to the patient\'s recovery. Patients with diabetes are prone to delayed gastric emptying. Different guidelines for preoperative carbohydrate consumption in patients with diabetes remain controversial due to concerns about the risk of regurgitation, aspiration and hyperglycemia. Ultrasonic gastric volume (GV) assessment and blood glucose monitoring can comprehensively evaluate the safety and feasibility of preoperative carbohydrate intake in type 2 diabetes (T2D) patients.
OBJECTIVE: To evaluate the impact of preoperative carbohydrate loading on GV before anesthesia induction in T2D patients.
METHODS: Patients with T2D receiving surgery under general anesthesia from December 2019 to December 2020 were included. A total of 78 patients were randomly allocated to 4 groups receiving 0, 100, 200, or 300 mL of carbohydrate loading 2 h before anesthesia induction. Gastric volume per unit weight (GV/W), Perlas grade, changes in blood glucose level, and risk of reflux and aspiration were evaluated before anesthesia induction.
RESULTS: No significant difference was found in GV/W among the groups before anesthesia induction (P > 0.05). The number of patients with Perlas grade II and GV/W > 1.5 mL/kg did not differ among the groups (P > 0.05). Blood glucose level increased by > 2 mmol/L in patients receiving 300 mL carbohydrate drink, which was significantly higher than that in groups 1 and 2 (P < 0.05).
CONCLUSIONS: Preoperative carbohydrate loading < 300 mL 2 h before induction of anesthesia in patients with T2D did not affect GV or increase the risk of reflux and aspiration. Blood glucose levels did not change significantly with preoperative carbohydrate loading of < 200 mL. However, 300 mL carbohydrate loading may increase blood glucose levels in patients with T2D before induction of anesthesia.
OBJECTIVE: To evaluate the impact of preoperative carbohydrate loading on GV before anesthesia induction in T2D patients.
METHODS: Patients with T2D receiving surgery under general anesthesia from December 2019 to December 2020 were included. A total of 78 patients were randomly allocated to 4 groups receiving 0, 100, 200, or 300 mL of carbohydrate loading 2 h before anesthesia induction. Gastric volume per unit weight (GV/W), Perlas grade, changes in blood glucose level, and risk of reflux and aspiration were evaluated before anesthesia induction.
RESULTS: No significant difference was found in GV/W among the groups before anesthesia induction (P > 0.05). The number of patients with Perlas grade II and GV/W > 1.5 mL/kg did not differ among the groups (P > 0.05). Blood glucose level increased by > 2 mmol/L in patients receiving 300 mL carbohydrate drink, which was significantly higher than that in groups 1 and 2 (P < 0.05).
CONCLUSIONS: Preoperative carbohydrate loading < 300 mL 2 h before induction of anesthesia in patients with T2D did not affect GV or increase the risk of reflux and aspiration. Blood glucose levels did not change significantly with preoperative carbohydrate loading of < 200 mL. However, 300 mL carbohydrate loading may increase blood glucose levels in patients with T2D before induction of anesthesia.
摘要：
背景：促进术后恢复主张在麻醉前两小时摄入碳水化合物有利于患者的恢复。糖尿病患者容易出现胃排空延迟。由于对返流风险的担忧，糖尿病患者术前碳水化合物消耗的不同指南仍存在争议。误吸和高血糖。超声胃容积(GV)评估和血糖监测可综合评价2型糖尿病(T2D)患者术前碳水化合物摄入的安全性和可行性。
目的：评估术前碳水化合物负荷对T2D患者麻醉诱导前GV的影响。
方法：纳入2019年12月至2020年12月在全身麻醉下接受手术的T2D患者。将78例患者随机分为4组，在麻醉诱导前2小时接受0、100、200或300mL碳水化合物负荷。单位重量的胃体积（GV/W），Perlas等级,血糖水平的变化，在麻醉诱导前评估反流和误吸的风险。
结果：麻醉诱导前各组GV/W比较差异无统计学意义(P>0.05)。PerlasII级和GV/W>1.5mL/kg的患者人数在各组间无差异(P>0.05)。接受300mL碳水化合物饮料的患者血糖水平增加>2mmol/L，显著高于第1组和第2组(P<0.05)。
结论：T2D患者在麻醉诱导前2小时的术前碳水化合物负荷<300mL并不影响GV或增加反流和误吸的风险。术前碳水化合物负荷<200mL时，血糖水平没有显着变化。然而,300mL碳水化合物负荷可能会增加麻醉诱导前T2D患者的血糖水平。
目的：评估术前碳水化合物负荷对T2D患者麻醉诱导前GV的影响。
方法：纳入2019年12月至2020年12月在全身麻醉下接受手术的T2D患者。将78例患者随机分为4组，在麻醉诱导前2小时接受0、100、200或300mL碳水化合物负荷。单位重量的胃体积（GV/W），Perlas等级,血糖水平的变化，在麻醉诱导前评估反流和误吸的风险。
结果：麻醉诱导前各组GV/W比较差异无统计学意义(P>0.05)。PerlasII级和GV/W>1.5mL/kg的患者人数在各组间无差异(P>0.05)。接受300mL碳水化合物饮料的患者血糖水平增加>2mmol/L，显著高于第1组和第2组(P<0.05)。
结论：T2D患者在麻醉诱导前2小时的术前碳水化合物负荷<300mL并不影响GV或增加反流和误吸的风险。术前碳水化合物负荷<200mL时，血糖水平没有显着变化。然而,300mL碳水化合物负荷可能会增加麻醉诱导前T2D患者的血糖水平。
