EFFECT OF PREOPERATIVE ORAL CARBOHYDRATE LOADING ON INTRAOPERATIVE BLOOD GLUCOSE LEVELS AND POSTOPERATIVE NAUSEA AND VOMITING

Abstract

BACKGROUND: Central to the development of a catabolic state after surgical trauma is the onset of a temporary loss of tissue sensitivity to circulating levels of insulin, the most powerful anabolic hormone. The degree and duration of postoperative insulin resistance are related to the extent of the surgical procedure and postoperative stress-hormone concentrations, especially cortisol, but also to the systemic inflammatory response. Thus, this study aims to study the effect of preoperative oral carbohydrate loading on intraoperative blood glucose levels and postoperative nausea and vomiting. OBJECTIVES: To assess the effect of a carbohydrate drink given 2 hours before surgery on intraoperative blood glucose levels and postoperative nausea and vomiting compared to those who did not receive the drink. MATERIALS AND METHODS: Seventy consenting patients will be arbitrarily segregated into two groups of 35 each in a randomized controlled study. Group A will be given 100gm of carbohydrate in 250 mL of plain water 2 h before surgery and group B patients will be given equivalent volume of plain water 2 h before surgery. Random blood glucose (RBS) levels were checked before fluid xvi administration, pre-induction, 1 h postinduction, and at the end of surgery. PONV was assessed using the PONV Impact Scale Score (ISS) and rescue drugs, if needed, were noted. RESULTS: Group B showed a significant increase in blood sugars intra-operative compared to their initial level. Group A showed no notable difference in blood sugars throughout the 1-hour intra-operative time and post-operative when compared to the initial baseline readings. Group A has fewer episodes of PONV compared to Group B. CONCLUSION: The current study demonstrates that the consumption of carbohydrates before surgery has been found to enhance vital signs and decrease PONV.