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Preoperative Carbohydrate Drinks Do Not Decrease Postoperative Nausea and Vomiting in Type 2 Diabetic Patients Undergoing Total Knee Arthroplasty-A Randomized Controlled Trial

Authors
 Seokyung Shin  ;  Yong Seon Choi  ;  Hyejung Shin  ;  Ick Hwan Yang  ;  Kwan Kyu Park  ;  Hyuck Min Kwon  ;  Byunghag Kang  ;  So Yeon Kim 
Citation
 JOURNAL OF THE AMERICAN ACADEMY OF ORTHOPAEDIC SURGEONS, Vol.29(1) : 35-43, 2021-01 
Journal Title
JOURNAL OF THE AMERICAN ACADEMY OF ORTHOPAEDIC SURGEONS
ISSN
 1067-151X 
Issue Date
2021-01
Abstract
Introduction: We evaluated whether preoperative carbohydrate drink would be able to decrease postoperative nausea and vomiting (PONV) and improve the quality of recovery (QoR) in diabetic patients undergoing total knee arthroplasty (TKA).

Methods: Eighty-two patients were randomized to either the intravenous (IV) Dextrose group (n = 41) or Oral carbohydrate (CHO) group (n = 41). The IV Dextrose group received dextrose solution mixed with insulin while fasting, and the Oral CHO group received carbohydrate drinks preoperatively. PONV was assessed up to postoperative 36 hours, and QoR was assessed before surgery and on postoperative day (POD) 1. Blood glucose was measured from the morning of surgery until POD 1.

Results: PONV scores were not different between the groups. Postoperative QoR scores were significantly higher in the Oral CHO group (median [interquartile range]; 160 [153 to 167]) than the IV Dextrose group (155 [147 to 159]) (P = 0.009), but the difference did not meet the minimal clinically important difference. Blood glucose was comparable between the groups.

Discussion: Preoperative CHO drink did not reduce PONV in diabetic patients after total knee arthroplasty. A statistically significant but clinically questionable improvement in the QoR was seen in the Oral CHO group. However, preoperative CHO drink did not increase hyperglycemia, which suggests that it may be a safe component of perioperative care in diabetic patients.

Trial registration: ClinicalTrials.gov NCT02432781.
Full Text
https://journals.lww.com/jaaos/Fulltext/2021/01010/Preoperative_Carbohydrate_Drinks_Do_Not_Decrease.5.aspx
DOI
10.5435/JAAOS-D-20-00089
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Anesthesiology and Pain Medicine (마취통증의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Orthopedic Surgery (정형외과학교실) > 1. Journal Papers
Yonsei Authors
Kwon, Hyuck Min(권혁민) ORCID logo https://orcid.org/0000-0002-2924-280X
Kim, So Yeon(김소연) ORCID logo https://orcid.org/0000-0001-5352-157X
Park, Kwan Kyu(박관규) ORCID logo https://orcid.org/0000-0003-0514-3257
Shin, Seokyung(신서경) ORCID logo https://orcid.org/0000-0002-2641-0070
Yang, Ick Hwan(양익환)
Choi, Yong Seon(최용선) ORCID logo https://orcid.org/0000-0002-5348-864X
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/181977
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