Enhanced muscle strength with carbohydrate supplement two hours before open cholecystectomy: a randomized, double-blind study

Objective: to investigate the effects of preoperative fasting abbreviation with oral supplementation with carbohydrate in the evolution of grip strength in patients undergoing cholecystectomy by laparotomy. Methods : we conducted a clinical, randomizeddouble blind study with adult female patients, aged 18-60 years. Patients were divided into two groups: Control Group, with fasting prescription 6-8h until the time of operation; and Intervention Group, which received prescription of fasting for solids 6-8h before surgery, but ingested an oral supplement containing 12.5% carbohydrate, six (400ml) and two (200ml) hours before theprocedure. The handgrip strength was measured in both hands in both groups, at patient's admission (6h before surgery), the immediate pre-operative time (1h before surgery) and 12-18h postoperatively. Results : we analyzed 27 patients, 14 in the intervention group and 13 in the control group. There was no mortality. The handgrip strength (mean [standard deviation]) was significantly higher in the intervention group in the three periods studied, in at least one hand: preoperatively in the dominant hand (27.8 [2.6] vs 24.1 [3.7] kg; p=0.04), in the immediate preoperative in both hands, and postoperatively in the non-dominant hand (28.5 [3.0] vs 21.3 [5.9] kg; p=0.01). Conclusion : the abbreviation of preoperative fasting to two hours with drink containing carbohydrate improves muscle function in the perioperative period.

研究目的：探究术前缩短禁食时间并联合口服碳水化合物补充剂，对接受开腹胆囊切除术的18~60岁成年女性患者围手术期握力变化的影响。研究方法：本研究为临床随机双盲试验，纳入18~60岁成年女性患者作为受试者，将其随机分为两组：对照组采用术前6~8小时禁食的常规方案；干预组术前禁食固体食物时长仍为6~8小时，但分别于术前6小时（口服400ml含12.5%碳水化合物的补充剂）及术前2小时（口服200ml同类型补充剂）。分别于患者入院时（术前6小时）、术前即刻（术前1小时）及术后12~18小时，对两组受试者双手握力进行测量。研究结果：本研究共纳入27例患者，其中干预组14例，对照组13例，无死亡病例。两组握力均值[标准差]在三个观测时间点的至少一侧手部均存在显著组间差异：术前优势手握力干预组为27.8[2.6]kg，对照组为24.1[3.7]kg（p=0.04）；术前即刻双侧手部握力均有显著差异；术后非优势手握力干预组为28.5[3.0]kg，对照组为21.3[5.9]kg（p=0.01）。研究结论：将术前禁食时长缩短至2小时并联合口服碳水化合物补充剂，可改善患者围手术期肌肉功能。