| OBJECTIVE: To evaluate the effect of carbohydrate loading on pediatric laparoscopic hernia preparation before surgery,and its effect on preoperative gastric emptying capacity,insulin resistance hunger score,induced quality score,recovery quality score,and parental satisfaction.Determine the effectiveness and safety of preoperative water compound load.Methods: Sixty children with laparoscopic hernia surgery were selected in our hospital from January 2019 to December 2019.The patients were divided into 3 groups(n=20)by random number table method: carbohydrate group(CHO group),placebo group(P group)and blank control group(C group).The CHO group took 15ml/kg carbohydrate drinks(containing carbohydrates 14.1g/100m1)2 hours before surgery,and the P group took 15m/kg distilled water 2 hours before surgery.The patients in group C were fasted and fasted according to the recommended strategy before surgery.The patients in all three groups chose elective surgery in the morning.Because of midnight sleep,the fasting and at least 6 hours of fasting and 4 hours before oral liquid administration were ensured in the liquid taking group(CHO group,P group).Hours of fasting.The three groups of patients underwent gastric ultrasound scanning during morning fasting(T1)and immediately before entering the room(T2)to measure the upper and lower diameters(D1)and anteroposterior diameter(D2)of the right lateral position(RLD)gastric antrum,and Cross-sectional area of the gastric antrum(CSA)of this slice was used to classify the gastric antrum and estimate the patient's gastric content(Gastric Volume,GV)and kilogram-weight stomach volume(GVW)at this time;use p H test paper respectively Measure the p H of the oral cavity before induction,the oropharynx before intubation,and the tip of the tracheal intubation after extubation;take fasting at T1 and immediately after the operation(T4)to take peripheral venous blood to measure blood glucose and insulin levels,using steady-state mode The evaluation method calculates the insulin resistance index at different times;record the hunger and thirst scores of the child at T2(inquire the child and his family during the bed change),and the induction quality score at the end of induction(T3);during recovery in the recovery room Evaluate the recovery quality score of the recovery room,record the postoperative nausea and vomiting,and the parental satisfaction score when returning to the ward.Results: There was no significant difference in gastric antrum cross-sectional area,calculated gastric volume,and kilogram weight stomach volume at time T1(P>0.05);compared with time T1,CHO group T2 cross-sectional area,calculated gastric volume,kg Body weight and stomach volume decreased(P<0.05),and there was no statistically significant difference in T1 and T2 between group P and group C(P>0.05);differences between the three groups before induction of the oral cavity,pre-intubation oropharynx,and catheter tip after extubation No statistical significance(P>0.05);CHO group has lower insulin resistance than P and C groups(P<0.05);CHO group has lower thirst and hunger scores than P and C groups(P<0.05)Satisfaction score was greater than that in group P and group C(P<0.05),and there was no statistically significant difference in the incidence of induction quality score,recovery room score,and nausea and vomiting(P>0.05)Conclusion: It is safe and effective for children to carry out laparoscopic hernia surgery for individualized carbohydrate load,which can reduce the stomach content volume to a certain extent,reduce the child's insulin resistance,reduce the child's thirst and hunger,and increase the Satisfaction with surgical anesthesia,but this study has not found that preoperative carbohydrate load has a significant effect on postoperative nausea and vomiting and induction,and postoperative recovery scores. |
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