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Preoperative gastric emptying: the effects of anxiety and carbohydrate administration
Department of Surgery, Karolinska Hospital, Stockholm, Sweden.
Department of Surgery, Karolinska Hospital, Stockholm, Sweden.
Department of Diagnostic Radiology, Karolinska Hospital, Stockholm, Sweden.
Department of Hospital Physics, Karolinska Hospital, Stockholm, Sweden.
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1995 (English)In: Annals of Surgery, ISSN 0003-4932, E-ISSN 1528-1140, Vol. 222, no 6, p. 728-734Article in journal (Refereed) Published
Abstract [en]

Background: Overnight fasting is routine before elective surgery. This may not be the optimal way to prepare for surgical stress, however, because intravenous carbohydrate supplementation instead of fasting has recently been shown to reduce postoperative insulin resistance. In the current study, gastric emptying of a carbohydrate-rich drink was investigated before elective surgery and in a control situation. Methods: Twelve patients scheduled for elective surgery were randomly given 400 mL of either a carbohydrate-rich drink (285 mOsm/kg, 12.0% carbohydrates, n = 6) or water 4 hours before being anesthetized. Gastric emptying was measured (gamma camera, 99Tcm). Each patient repeated the protocol postoperatively as a control. All values were presented as the mean ± SEM by means of a nonparametric statistical evaluation. Results: Despite the increased anxiety experienced by patients before surgery (p < 0.005), gastric emptying did not differ between the experimental and control situations. Initially, water emptied more rapidly than carbohydrate. However, after 90 minutes, the stomach was emptied regardless of the solution administered (3.2 ± 1.1% [mean ± SEM] remaining in the stomach in the carbohydrate group versus 2.3 ± 1.2% remaining in the stomach in the water group). Conclusions: Preoperative anxiety does not prolong gastric emptying. The stomach had been emptied 90 minutes after ingestion of both the carbohydrate-rich drink and water, thereby indicating the possibility of allowing an intake of iso-osmolar carbohydrate-rich fluids before surgery.

Place, publisher, year, edition, pages
Lippincott Williams & Wilkins, 1995. Vol. 222, no 6, p. 728-734
National Category
Anesthesiology and Intensive Care
Identifiers
URN: urn:nbn:se:oru:diva-63862DOI: 10.1097/00000658-199512000-00006ISI: A1995TJ31400006PubMedID: 8526579Scopus ID: 2-s2.0-0029610737OAI: oai:DiVA.org:oru-63862DiVA, id: diva2:1170987
Available from: 2018-01-05 Created: 2018-01-05 Last updated: 2018-02-05Bibliographically approved

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