The Security And Effect Of The Carbohydrate Load On The Preoperative Preparation With Cesarean

Objective To evaluate the comfort of cesarean section and the effects of the postoperative blood sugar and the insulin resistance during the operation.Meth ods From March 2016 to July 2016 in the Genetal hospital of TianJin,40 pati ents who were going to get elective csection were selected and divided rando mly into two groups: oral carbohydrate group(CHO group,n=20),oral placebo group(P group,n=20).Both groups used epidural anesthesia,and a routine pre operative fasting.300 ml carbohydrate drinks(it contains 14.1 grams of carbohy drates per 100 ml of drink)was administrated orally 2 h before anesthesia in oral CHO group.Patients in oral placebo group were given an equal amount d istilled waster instead of carbohydrate.The gastric emptying situation was exami ned by ultrasonography,which can evaluate the safety of oral carbohydrate.Me asure anteroposterior diameter(AP)? Crnialcaudal diameter(CC)and this section antrum area at fasting,immediately after oral administration,2 h after oral ad ministration in group CHO.The levels of blood glucose(BG)?plasma insulin(I NS)?glucagons?plasma malonyldialdehyde(MDA)?superoxide dismutase1(S OD1)were tested after 2 h and after fetus delivery.According to levels of BG and INS,homeostasis model assessment(HOMA)was applied to calculate the index of insulin resistance(HOMA-IR)and insulin sensistivty index(HOMA-ISI).After fetus delivery tested neonates blood glucose immediately.Meanwhile,the i ncidence of nausea and vomiting at 0-12 h and 12-24 h postoperatively were r ecorded.Results Compared with fastingAP?Crnialcaudal diameter CC and gas tric antrum area at 2h after the oral carbohydrate were no statistics significant(P>0.05).Relieved hunger of CHO group [VAS(1.0±1.0)points] was less than P group [VAS(2.5±1.3)points].After fetus delivery,two groups blood glucose all elevated significantly(P<0.01).In P group has higher glucagons level(276±159)(ng/L)than the CHO group(154±151)(ng/L)and the HOMA-IR levels(6.5±3.8)had a significant rise,and the HOMA-ISI levels(-4.8±0.8)(mmol/l)had a significant decrease.Compared with group P,the concentration of serum MDA decreased in group CHO(P<0.05),The neonates blood glucose levels in the CHO group(3.5±0.6)(mmol/l)was higher than those in P group(3.9±0.6)(P<0.05).Conclusion Csection preoperative oral intake of carbohydrate c an safely reduce the insulin resistance and relieve the feelings of thirst,and he lp to raise blood glucose levels in newborns.