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Br J Anaesth:儿童全身麻醉前饮用碳水化合物与标准禁食的随机对照试验

2018-10-31 王贵龙 “罂粟花”微信号

术前给予碳水化合物可减少胃内容物,降低患儿术后恶心发生风险,这为儿童麻醉术前禁食标准的制定提供了依据。

背景与目的

术前禁食是儿科患者围术期不适的主要原因,且可导致术后胰岛素抵抗,从而增强手术炎症反应。患儿术前摄入碳水化合物是否可降低这些情况的发生,目前尚不清楚。

方  法

本试验共纳入2岁至18岁的患儿120例,随机分为对照组和试验组,对照组术前按照6h固体食物、4h母乳、2小时清饮的常规标准禁食,试验组在镜检查前夜和检查前2h各口服PreOp牌柠檬口味的碳水化合物溶液5ml/kg。在镜检查时通过胃镜吸除胃内容物,记录其容积和pH值。记录术前不适感评分、口渴和饥饿情况以及术后恶心呕吐发生情况 。四岁(含)以下使用观察性疼痛量表(OPS),四岁以上使用VAS评分

结  果

与对照组相比,试验组患儿胃内容物显着减少(p=0.01),术后恶心发生率更低(p=0.028),术后呕吐发生率无显着差异。试验组仅1例术前VAS评分大于5分,而对照组则有5例。合并肠镜检查组胃内容物体积并不高于单纯胃镜检查组,其他研究结果也与单纯胃镜检查组相同。

结  论

术前给予碳水化合物可减少胃内容物,降低患儿术后恶心发生风险,这为儿童麻醉术前禁食标准的制定提供了依据。

原始出处:

Tudor-Drobjewski BA, Marhofer P, Kimberger, et al. Randomised controlled trial comparing preoperative carbohydrate loading with standard fasting in paediatric anaesthesia. Br J Anaesth. 2018 Sep;121(3):656-661. doi: 10.1016/j.bja.2018.04.040

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    2018-12-28 amyloid
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    2019-08-25 AspirantSuo
  5. [GetPortalCommentsPageByObjectIdResponse(id=1987230, encodeId=6ff7198e230a2, content=<a href='/topic/show?id=bac5466546c' target=_blank style='color:#2F92EE;'>#对照试验#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=76, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=46654, encryptionId=bac5466546c, topicName=对照试验)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=ad9f79, createdName=般若傻瓜, createdTime=Wed Feb 06 00:04:00 CST 2019, time=2019-02-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2051274, encodeId=39c820512e490, content=<a href='/topic/show?id=95f8e042dd' target=_blank style='color:#2F92EE;'>#EST#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=72, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7042, encryptionId=95f8e042dd, topicName=EST)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e9a6357, createdName=xiangyuzhou971, createdTime=Mon Dec 03 12:04:00 CST 2018, time=2018-12-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1775430, encodeId=4d3b1e75430e5, content=<a href='/topic/show?id=937d46650bf' target=_blank style='color:#2F92EE;'>#对照#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=82, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=46650, encryptionId=937d46650bf, topicName=对照)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8ae138776909, createdName=amyloid, createdTime=Fri Dec 28 09:04:00 CST 2018, time=2018-12-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1633495, encodeId=bff01633495f1, content=<a href='/topic/show?id=377824e1c0' target=_blank style='color:#2F92EE;'>#ANA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=71, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2471, encryptionId=377824e1c0, topicName=ANA)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=434d22047430, createdName=AspirantSuo, createdTime=Sun Aug 25 23:04:00 CST 2019, time=2019-08-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1906397, encodeId=8b90190639eb6, content=<a href='/topic/show?id=7795334e220' target=_blank style='color:#2F92EE;'>#化合物#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=69, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=33472, encryptionId=7795334e220, topicName=化合物)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=267e204, createdName=wangyang7958, createdTime=Sat Jan 26 12:04:00 CST 2019, time=2019-01-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1296210, encodeId=e50812962102b, content=<a href='/topic/show?id=7591984530b' target=_blank style='color:#2F92EE;'>#随机对照试验#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=66, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=98453, encryptionId=7591984530b, topicName=随机对照试验)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=373b263, createdName=lisa438, createdTime=Fri Nov 02 04:04:00 CST 2018, time=2018-11-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1464371, encodeId=ffe414643e106, content=<a href='/topic/show?id=9b04641580e' target=_blank style='color:#2F92EE;'>#水化#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=94, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=64158, encryptionId=9b04641580e, topicName=水化)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=f1276671681, createdName=yuanming9, createdTime=Fri Nov 02 04:04:00 CST 2018, time=2018-11-02, status=1, ipAttribution=)]
  6. [GetPortalCommentsPageByObjectIdResponse(id=1987230, encodeId=6ff7198e230a2, content=<a href='/topic/show?id=bac5466546c' target=_blank style='color:#2F92EE;'>#对照试验#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=76, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=46654, encryptionId=bac5466546c, topicName=对照试验)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=ad9f79, createdName=般若傻瓜, createdTime=Wed Feb 06 00:04:00 CST 2019, time=2019-02-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2051274, encodeId=39c820512e490, content=<a href='/topic/show?id=95f8e042dd' target=_blank style='color:#2F92EE;'>#EST#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=72, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7042, encryptionId=95f8e042dd, topicName=EST)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e9a6357, createdName=xiangyuzhou971, createdTime=Mon Dec 03 12:04:00 CST 2018, time=2018-12-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1775430, encodeId=4d3b1e75430e5, content=<a href='/topic/show?id=937d46650bf' target=_blank style='color:#2F92EE;'>#对照#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=82, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=46650, encryptionId=937d46650bf, topicName=对照)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8ae138776909, createdName=amyloid, createdTime=Fri Dec 28 09:04:00 CST 2018, time=2018-12-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1633495, encodeId=bff01633495f1, content=<a href='/topic/show?id=377824e1c0' target=_blank style='color:#2F92EE;'>#ANA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=71, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2471, encryptionId=377824e1c0, topicName=ANA)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=434d22047430, createdName=AspirantSuo, createdTime=Sun Aug 25 23:04:00 CST 2019, time=2019-08-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1906397, encodeId=8b90190639eb6, content=<a href='/topic/show?id=7795334e220' target=_blank style='color:#2F92EE;'>#化合物#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=69, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=33472, encryptionId=7795334e220, topicName=化合物)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=267e204, createdName=wangyang7958, createdTime=Sat Jan 26 12:04:00 CST 2019, time=2019-01-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1296210, encodeId=e50812962102b, content=<a href='/topic/show?id=7591984530b' target=_blank style='color:#2F92EE;'>#随机对照试验#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=66, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=98453, encryptionId=7591984530b, topicName=随机对照试验)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=373b263, createdName=lisa438, createdTime=Fri Nov 02 04:04:00 CST 2018, time=2018-11-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1464371, encodeId=ffe414643e106, content=<a href='/topic/show?id=9b04641580e' target=_blank style='color:#2F92EE;'>#水化#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=94, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=64158, encryptionId=9b04641580e, topicName=水化)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=f1276671681, createdName=yuanming9, createdTime=Fri Nov 02 04:04:00 CST 2018, time=2018-11-02, status=1, ipAttribution=)]
  7. [GetPortalCommentsPageByObjectIdResponse(id=1987230, encodeId=6ff7198e230a2, content=<a href='/topic/show?id=bac5466546c' target=_blank style='color:#2F92EE;'>#对照试验#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=76, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=46654, encryptionId=bac5466546c, topicName=对照试验)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=ad9f79, createdName=般若傻瓜, createdTime=Wed Feb 06 00:04:00 CST 2019, time=2019-02-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2051274, encodeId=39c820512e490, content=<a href='/topic/show?id=95f8e042dd' target=_blank style='color:#2F92EE;'>#EST#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=72, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7042, encryptionId=95f8e042dd, topicName=EST)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e9a6357, createdName=xiangyuzhou971, createdTime=Mon Dec 03 12:04:00 CST 2018, time=2018-12-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1775430, encodeId=4d3b1e75430e5, content=<a href='/topic/show?id=937d46650bf' target=_blank style='color:#2F92EE;'>#对照#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=82, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=46650, encryptionId=937d46650bf, topicName=对照)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8ae138776909, createdName=amyloid, createdTime=Fri Dec 28 09:04:00 CST 2018, time=2018-12-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1633495, encodeId=bff01633495f1, content=<a href='/topic/show?id=377824e1c0' target=_blank style='color:#2F92EE;'>#ANA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=71, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2471, encryptionId=377824e1c0, topicName=ANA)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=434d22047430, createdName=AspirantSuo, createdTime=Sun Aug 25 23:04:00 CST 2019, time=2019-08-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1906397, encodeId=8b90190639eb6, content=<a href='/topic/show?id=7795334e220' target=_blank style='color:#2F92EE;'>#化合物#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=69, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=33472, encryptionId=7795334e220, topicName=化合物)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=267e204, createdName=wangyang7958, createdTime=Sat Jan 26 12:04:00 CST 2019, time=2019-01-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1296210, encodeId=e50812962102b, content=<a href='/topic/show?id=7591984530b' target=_blank style='color:#2F92EE;'>#随机对照试验#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=66, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=98453, encryptionId=7591984530b, topicName=随机对照试验)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=373b263, createdName=lisa438, createdTime=Fri Nov 02 04:04:00 CST 2018, time=2018-11-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1464371, encodeId=ffe414643e106, content=<a href='/topic/show?id=9b04641580e' target=_blank style='color:#2F92EE;'>#水化#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=94, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=64158, encryptionId=9b04641580e, topicName=水化)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=f1276671681, createdName=yuanming9, createdTime=Fri Nov 02 04:04:00 CST 2018, time=2018-11-02, status=1, ipAttribution=)]
    2018-11-02 yuanming9
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