Preoperative carbohydrate drink in fast-track primary total knee arthroplasty: a randomized controlled trial of 168 patients.

IF 0.5 4区 医学 Q4 ORTHOPEDICS
J C Van Egmond, N H H De Esch, H Verburg, N T Van Dasselaar, N M C Mathijssen
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引用次数: 0

Abstract

A key component in fast-track total knee arthroplasty (TKA) is early mobilization. Preoperative fasting might cause orthostatic hypotension and -intolerance which both can interfere with early mobilization. It was hypothesized that consuming a carbohydrate drink 2-3 hours prior to surgery is a viable option to reduce orthostatic hypotension, and as a result, improve rehabilitation. In this randomized controlled trial, all consecutive unilateral primary TKA patients were reviewed for eligibility. Exclusion criteria were American Society of Anesthesiologists (ASA) class above 3, older than 80 years of age, Diabetes Mellitus, and an insufficient comment of Dutch language. Patients were distributed in two groups. The control group was allowed to eat till 6 hours and drink clear fluids till 2 hours before surgery (standard treatment). The intervention group consumed, additionally to the standard treatment, a carbohydrate drink 2-3 hours before surgery. Blood pressure was measured both lying and standing as a measure for orthostatic hypotension during first time postoperative mobilization on day of surgery. A total of 168 patients were included. Prevalence of orthostatic hypotension in the control- and intervention group was 24 patients (34%) and 14 patients (19%) respectively, (p=0.05). Prevalence of orthostatic intolerance was 13 patients (19%) in the control group and 9 patients (13%) in the intervention group (p=0.32). No drink related adverse events occurred. In conclusion, taking a carbohydrate drink 2-3 hours before TKA significantly lowers the number of patients with orthostatic hypotension in early mobilization. However, the clinical relevance of the carbohydrate drink has to be studied further.

术前碳水化合物饮料在快速原发性全膝关节置换术中的应用:一项168名患者的随机对照试验。
快速全膝关节置换术(TKA)的一个关键组成部分是早期动员。术前禁食可能导致直立性低血压和不耐受,这两种情况都会干扰早期动员。据推测,在手术前2-3小时饮用碳水化合物饮料是减少直立性低血压的可行选择,从而改善康复。在这项随机对照试验中,对所有连续的单侧原发性TKA患者的资格进行了审查。排除标准为美国麻醉师协会(ASA)3级以上、80岁以上、糖尿病和荷兰语评论不足。患者分为两组。对照组手术前进食至6小时,饮水至2小时(标准治疗)。除标准治疗外,干预组在手术前2-3小时饮用碳水化合物饮料。在手术当天第一次术后动员期间,测量躺着和站着的血压,作为直立性低血压的测量标准。共纳入168名患者。对照组和干预组直立性低血压的患病率分别为24名患者(34%)和14名患者(19%),(p=0.05)。对照组直立性不耐受的患病率为13名患者(19%),干预组为9名患者(13%)(p=0.32)。未发生与饮酒相关的不良事件。总之,TKA前2-3小时服用碳水化合物饮料可显著降低早期活动期直立性低血压患者的数量。然而,碳水化合物饮料的临床相关性还有待进一步研究。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Acta orthopaedica Belgica
Acta orthopaedica Belgica 医学-整形外科
CiteScore
0.70
自引率
0.00%
发文量
58
审稿时长
4-8 weeks
期刊介绍: Information not localized
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