Clinical Investigation Regarding The Effect Of Preoperative Administration Of Oral Glucose On Gynecological Patients Undergoing Selective Operation

Objective: To observe the effect of preoperative oral glucose solution on the patients who would receive selective operation with general anesthesia.Methods: A total of 60 female patients who suffered from gynecological benign neoplasm and thereby would receive selective operation with general anesthesia were enrolled at The First Hospital of Jilin University,from January2017 to January 2018.Patients meeting the following criteria were included:ASA degree I-II;18-65 years old;body mass index(BMI)18-28kg/m2.Patients with the following conditions were beyond the scope of this study:(1)the exact diagnosis of diabetes or other metabolic disorders,such as hyperthyroidism and hypothyroidism;(2)gastrointestinal obstruction or weakened gastric motility such as delayed gastric emptying and gastroesophageal reflux;(3)dysfunction of heart,liver or kidney;(4)fever or other potentially infected symptoms;(5)disapproval on the involvement of this study.The involved individuals were randomized to the observation group(group A,n = 30)and the control group(group B,n = 30).Each Patient in group A was given 10% oral glucose 800 ml at 10 p.m.,one day before surgery.Besides,another oral glucose(10%,400 ml)was provided 3 hours before the beginning of surgery.By contrast,the patients in group B was treated with a traditional strategy,which is that the patients should keep the state of fasting and water deprivation from 10 p.m.,one day before the operation to the beginning of operation.Neither group A nor group B had received any infusionuntil the initiation of anesthesia induction.The recorded parameters from all participants included: preoperative VAS score,the level of perioperative blood glucose,the level of temperature and the dosage of vasopressor agent during the surgery,postoperative breaking wind time and the length of hospital stay.Results:(1)On the basis of the estimation using VAS,scores regarding the sense of hunger,thirst and anxiety in group A were significantly lower than that in group B(p<0.05).By contrast,there were no significant differences in the scores of fatigue and nausea between the two groups(p>0.05).(2)For either group A or group B,in comparison with the respective level of fasting blood-glucose(FBG)at admission,the variation in the level of FBG on the morning of surgery was not significant(p>0.05).The level of blood glucose in group A at the beginning of anesthesia induction was apparently,but not significantly,lower than that at admission(p>0.05).However,the level of blood glucose in group B at this point was significantly lower than that at admission(p<0.05).Both group A and group B shown elevated levels of blood glucose at the mid-term of anesthesia.Whereas the variation in group A was not significant(p>0.05),the variation in group B was obvious(p<0.05).In the subsequent time period,the various trend of blood-glucose level in the two groups was consistent.The peak levels emerged at one day after surgery,and then gradually declined.Nonetheless,the levels of glucose in the two groups at discharge remained significantly higher than that at admission(p<0.05).(3)There were no significant differences between the two groups in the levels of temperature during the period of operation.The difference in the occurrence rate of chill was not significant likewise.(4)The total dosage of noradrenaline used during the operation in group A was significantly lower than that in group B(p<0.05).(5)There were no significant differences between the two groupsin neither the interval from completion of operation to the first time when breaking wind nor the length of hospital stay.Conclusions:(1)Oral glucose solution preoperatively would contribute to the improvement of the sense of hunger,thirst and anxiety for the gynecological patients undergoing selective operation.(2)Preoperative administration of oral glucose solution would be beneficial for the maintenance of the level of blood glucose during the operation.However,it seems not to be helpful to reduce the increased extent of blood glucose,despite it would delay the emergence of high level of blood glucose due to stress response.(3)Oral glucose solution taken in advance would reduce the dosage of noradrenaline during the operation,and thereby maintain the perioperative hemodynamics.