The effects of carbohydrate-rich drink on perioperative discomfort, insulin response and arterial pressure in spinal aesthesia

Abstract

Background: The aim of this study was to investigate the role of carbohydrate-rich drink (CHO) on perioperative discomfort, hemodynamic changes, and insulin response in patients undergoing surgery with spinal anesthesia.

Methods: Forty-four adult patients were assigned to one of the two groups of 22, namely preparation with CHO (CHO group) or fasting from midnight (control group). Ten different discomfort variables, blood glucose and insulin concentrations, and hemodynamic changes were recorded during the perioperative period.

Results: Preparation with CHO was effective in reducing hunger, thirst, malaise, unfitness, and, to some extent, anxiety (p < 0.05). Plasma glucose and insulin concentrations were increased in the CHO group (p < 0.05). Plasma glucose increased and insulin decreased in the control group (p < 0.05). In the control group, mean arterial pressure was lower compared to the CHO group (p < 0.05).

Conclusions: Preparation with CHO before spinal anesthesia is advantageous due to reducing perioperative discomfort, improving insulin response and stabilizing mean arterial pressure.

Keywords: Fasting; Humans; Insulin Sensitivity; Oral Carbohydrate; Perioperative Discomfort; Spinal Anesthesia; Surgery.

Figure 1

Perioperative plasma glucose concentration (mg/dl) in the two groups. Data are presented means ± SD. BI = before intake of the morning drink (or corresponding time in the fasted group); AI = after intake of the morning drink (or corresponding time in the fasted group); 60 min SA = 60 min after the spinal anesthesia; * p < 0.05 compared to BI; † p < 0.05 compared to the other group.

Figure 2

Perioperative plasma insulin concentration (microunits/ml) Data are means±SD. BI = before intake of the morning drink (or corresponding time in the Fasted group); AI = after intake of the morning drink (or corresponding time in the Fasted group); 60 min SA = 60 min after the spinal anesthesia; * p<0.05 compared to BI; †p<0.05 compared to the other group.