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Preoperative Carbohydrate Drinks Do Not Decrease Postoperative Nausea and Vomiting in Type 2 Diabetic Patients

Seokyung Shin1, Yong Seon Choi, Hyejung Shin

  • 1From the Department of Anesthesiology and Pain Medicine (Dr. Seokyung Shin, Dr. Choi, Dr. Kang, and Dr. Kim), the Anesthesia and Pain Research Institute (Dr. Seokyung Shin, Dr. Choi, Dr. Kang, and Dr. Kim), Yonsei University College of Medicine, the Department of Research Affairs (Dr. Hyejung Shin), Biostatistics Collaboration Unit, Yonsei University College of Medicine, and the Department of Orthopedic Surgery (Dr. Yang, Dr. Park, and Dr. Kwon), Yonsei University College of Medicine, Seoul, Korea.

The Journal of the American Academy of Orthopaedic Surgeons
|May 21, 2020
PubMed
Summary
This summary is machine-generated.

Preoperative carbohydrate drinks did not reduce postoperative nausea and vomiting in diabetic patients undergoing knee surgery. While quality of recovery improved slightly, it was not clinically significant, but the drinks were safe.

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Area of Science:

  • Anesthesiology
  • Metabolic Medicine
  • Orthopedic Surgery

Background:

  • Diabetic patients undergoing total knee arthroplasty (TKA) face risks of postoperative nausea and vomiting (PONV) and impaired quality of recovery (QoR).
  • Preoperative carbohydrate (CHO) loading is explored as a strategy to mitigate these complications.

Purpose of the Study:

  • To evaluate the efficacy of preoperative oral carbohydrate drinks versus intravenous dextrose in reducing PONV and improving QoR in diabetic patients undergoing TKA.
  • To assess the impact on perioperative blood glucose levels.

Main Methods:

  • Eighty-two diabetic patients undergoing TKA were randomized into two groups: intravenous (IV) dextrose with insulin or oral carbohydrate (CHO) drinks.
  • PONV was assessed for 36 hours postoperatively, QoR was measured pre- and post-surgery, and blood glucose levels were monitored until postoperative day 1.

Main Results:

  • No significant difference in PONV scores was observed between the oral CHO and IV dextrose groups.
  • The oral CHO group showed a statistically significant improvement in QoR scores, but the difference was below the minimal clinically important difference.
  • Blood glucose levels remained comparable between the groups throughout the study period.

Conclusions:

  • Preoperative oral carbohydrate drinks did not effectively reduce PONV in diabetic patients after TKA.
  • While QoR showed a statistically significant, albeit clinically questionable, improvement with oral CHO, the intervention did not induce hyperglycemia, suggesting potential safety for perioperative use in this population.