To Compare the Efficacy of Preoperative Oral 50 g of Maltodextrin versus 50 g of Glucose in Reducing Postoperative Nausea and Vomiting, in Patients Undergoing Laparoscopic Cholecystectomy under General Anesthesia: A Randomized Controlled Double-blind Study.

Abstract

Background: Postoperative nausea and vomiting (PONV) is the second most common complaint following general anesthesia. Despite multimodal strategies to reduce PONV, it still occurs in 20%-30% of patients. Major surgery induces metabolic changes, resulting in insulin resistance. Oral carbohydrate (CHO) loading 2 h before surgery modifies insulin resistance and improves postoperative patient comfort including reduction of PONV.

Patients and methods: The present study was a prospective, randomized controlled double-blinded study. 105 patients aged 18-60 years undergoing laparoscopic cholecystectomy under general anesthesia were randomized into three groups: M (50 mg of oral maltodextrin in 100 ml water), G (50 mg of oral glucose in 100 ml water), and C (100 ml of plain water). Each group received the samples 2 h before induction and underwent routine induction and intervention. Their vital parameters were monitored perioperatively and were also evaluated for PONV and perioperative comfort levels.

Results: Statistically significant relationship between the groups and postoperative comfort score (χ2 = 34.56, P ≤ 0.001, Cramé's V = 0.41). Analysis of variance test showed difference between the different groups and postextubation General Random Blood Sugar (GRBS) (F = 16.11, P ≤ 0.001). No significant difference was seen among the three groups in preoperative comfort scores (χ2 = 0.72, P = 0.699, Cramé's V = 0.08) and preoperative GRBS (P = 0.055).

Conclusion: It was concluded that the oral intake of CHO drink 2 h before surgery improves the comfort of patients by reducing preoperative hunger and thirst along with smaller postoperative glucose spike in the maltodextrin group.