Przedoperacyjna doustna podaż roztworu węglowodanów u dzieci — ocena tolerancji i odpowiedzi metabolicznej — doniesienie wstępne

Background: The need for long preoperative fasting has been questioned. Recent data shows that intake of oral carbohydrate-containing clear fluid prior to anaesthesia is safe and may have positive impact on recovery, metabolic status and improve glucose tolerance. Such solutions are routinely used in adults but not children. The aim of this study was to evaluate safety, tolerance and influence of oral carbohydrate on selected metabolic parameters in children.Methods: With the ethics committee approval and parental informed consent 20 children, aged 4–17 years, ASA status I or II, scheduled for abdominal or thoracic surgery were randomized to group 1 — receiving a 12.6% carbohydrate-containing drink (10 mL kg-1 the evening before surgery and 2 hours before anaesthesia) or control group 2 — fasting. Serum glucose and insulin concentration were measured four times: before and after anaesthesia, in the evening after surgery and the following morning. IGF-1 concentration was measured once, before surgery. Insulin resistance was assessed by the HOMA-IR equation.Results: Oral carbohydrate solution was well tolerated and no adverse events were noted. Glucose concentrations were within the normal range in both groups. Insulin concentration did not show significant differences between groups, however before surgery it tended to be lower in group 1. Insulin resistance after surgery was significantly higher in group 2 (2.0 vs. 0.62, P = 0.03), also the increase in insulin resistance after operation was significant only in control group (P = 0.03).Conclusion: Oral carbohydrates were safe, well tolerated and did not cause any perioperative adverse events. They seem to improve postoperative metabolism by decreasing insulin resistance.Background: The need for long preoperative fasting has been questioned. Recent data shows that intake of oral carbohydrate-containing clear fluid prior to anaesthesia is safe and may have positive impact on recovery, metabolic status and improve glucose tolerance. Such solutions are routinely used in adults but not children. The aim of this study was to evaluate safety, tolerance and influence of oral carbohydrate on selected metabolic parameters in children.Methods: With the ethics committee approval and parental informed consent 20 children, aged 4–17 years, ASA status I or II, scheduled for abdominal or thoracic surgery were randomized to group 1 — receiving a 12.6% carbohydrate-containing drink (10 mL kg-1 the evening before surgery and 2 hours before anaesthesia) or control group 2 — fasting. Serum glucose and insulin concentration were measured four times: before and after anaesthesia, in the evening after surgery and the following morning. IGF-1 concentration was measured once, before surgery. Insulin resistance was assessed by the HOMA-IR equation.Results: Oral carbohydrate solution was well tolerated and no adverse events were noted. Glucose concentrations were within the normal range in both groups. Insulin concentration did not show significant differences between groups, however before surgery it tended to be lower in group 1. Insulin resistance after surgery was significantly higher in group 2 (2.0 vs. 0.62, P = 0.03), also the increase in insulin resistance after operation was significant only in control group (P = 0.03).Conclusion: Oral carbohydrates were safe, well tolerated and did not cause any perioperative adverse events. They seem to improve postoperative metabolism by decreasing insulin resistance