کد مقاله | کد نشریه | سال انتشار | مقاله انگلیسی | نسخه تمام متن |
---|---|---|---|---|
5627167 | 1579669 | 2017 | 5 صفحه PDF | دانلود رایگان |
- Extension of the preoperative fasting period increases the magnitude of postoperative insulin resistance.
- The use of POC treatment in patients undergoing lumbar disc surgery did not attenuate the development of insulin resistance.
- The lack of insulin resistance may be associated with minimal development of insulin resistance following lumbar disc surgery.
ObjectivesSurgical trauma produces metabolic and hormonal responses, which are characterized by insulin resistance. Due to extension of the preoperative fasting period, which increases the magnitude of postoperative insulin resistance, preoperative oral carbohydrates (POC) have been developed.Patients and methodsThis prospective, randomized, controlled study was performed on 43 ASA I-II patients undergoing elective microsurgical lumbar discectomy. The intervention group received oral carbohydrate solution 800Â mL the night before and 400Â mL 2Â h prior to operation. The other group fasted for 8Â h prior to operation. Blood samples were obtained the day before the operation, before induction of anesthesia, after skin incision, 1Â h, 2Â h, 6Â h and 24Â h following skin incision. Blood glucose, plasma insulin, cortisol and interleukin-6 (IL-6) levels were determined. The primary endpoint was to assess the effect of POC treatment on insulin resistance and surgical stress response following lumbar disc surgery. The secondary endpoint was to assess POC's effects on postoperative nausea and vomiting.ResultsThe serum insulin levels were higher before induction of anesthesia in the study group and returned to fasted group levels by 2Â h after skin incision. The plasma IL-6 levels were higher in the intervention group at 6Â h after the skin incision. There were no differences between the two groups with respect to blood glucose, plasma cortisol levels and the incidence of nausea and vomiting.ConclusionThis study suggests that use of POC treatment does not attenuate development of insulin resistance in patients undergoing lumbar disc surgery.
Journal: Clinical Neurology and Neurosurgery - Volume 153, February 2017, Pages 82-86