دورية أكاديمية
Effects of Preoperative Carbohydrate-rich Drinks on Immediate Postoperative Outcomes in Total Knee Arthroplasty: A Randomized Controlled Trial.
| العنوان: | Effects of Preoperative Carbohydrate-rich Drinks on Immediate Postoperative Outcomes in Total Knee Arthroplasty: A Randomized Controlled Trial. |
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| المؤلفون: | Kadado A; From Department of Orthopaedics, Henry Ford Hospital, Detroit, MI (Shaw, North, and Charters), Department of Orthopaedics, Nationwide Children's Hospital, Columbus, OH (Kadado), Department of Orthopaedics, Western Michigan University Homer Stryker M.D. School of Medicine, Kalamazoo, MI (Ayoola), and Department of Orthopaedics, Montefiore Medical Center, Bronx, NY (Akioyamen)., Shaw JH, Ayoola AS, Akioyamen NO, North WT, Charters MA |
| المصدر: | The Journal of the American Academy of Orthopaedic Surgeons [J Am Acad Orthop Surg] 2022 Jun 01; Vol. 30 (11), pp. e833-e841. Date of Electronic Publication: 2022 Mar 18. |
| نوع المنشور: | Journal Article; Randomized Controlled Trial |
| اللغة: | English |
| بيانات الدورية: | Publisher: Wolters Kluwer Country of Publication: United States NLM ID: 9417468 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1940-5480 (Electronic) Linking ISSN: 1067151X NLM ISO Abbreviation: J Am Acad Orthop Surg Subsets: MEDLINE |
| أسماء مطبوعة: | Publication: 2016- : Philadelphia : Wolters Kluwer Original Publication: Rosemont, IL : American Academy of Orthopaedic Surgeons, c1993- |
| مواضيع طبية MeSH: | Arthroplasty, Replacement, Knee*/adverse effects, Carbohydrates/therapeutic use ; Humans ; Pain/etiology ; Pain, Postoperative/drug therapy ; Pain, Postoperative/etiology ; Pain, Postoperative/prevention & control ; Postoperative Nausea and Vomiting/epidemiology ; Postoperative Nausea and Vomiting/etiology ; Postoperative Nausea and Vomiting/prevention & control ; Preoperative Care |
| مستخلص: | Background: This study investigates the effects of preoperative carbohydrate-rich drinks on postoperative outcomes after primary total knee arthroplasty. Methods: We prospectively randomized 153 consecutive patients undergoing primary total knee arthroplasty at one institution. Patients were assigned to one of three groups: group A (50 patients) received a carbohydrate-rich drink; group B (51 patients) received a placebo drink; and group C (52 patients) did not receive a drink (control). All healthcare personnel and patients were blinded to group allocation. Controlling for demographics, we analyzed the rate of postoperative nausea and vomiting, length of stay, opiate consumption, pain scores, serum glucose, adverse events, and intraoperative and postoperative fluid intake. Results: Demographics and comorbidities were similar among the groups. There were no significant differences in surgical interventions or experience. Surgical fluid intake and total blood loss were similar among the three groups (P = 0.47, P = 0.23). Furthermore, acute postoperative outcomes (ie, pain, episodes of nausea, and length of stay) were similar across all three groups. There were no significant differences in adverse events between the three groups (P = 0.13). There was a significant difference in one-time postoperative bolus between the three groups (P = 0.02), but after multivariate analysis, it did not demonstrate significance. None of the intervention group were readmitted, whereas 5.9% and 11.5% were readmitted in the placebo and control groups, respectively (P = 0.047). The chance of 90-day readmission was reduced in group A compared with group C (odds ratio, 0.08; 95% confidence interval, 0.01 to 0.72; P = 0.02). There were no differences in other postoperative outcome measurements. Conclusion: This randomized controlled trial demonstrated that preoperative carbohydrate loading does not improve immediate postoperative outcomes, such as nausea and vomiting; however, it demonstrated that consuming fluid preoperatively proved no increased risk of adverse outcomes and there was a trend toward decrease of one-time boluses postoperatively. Clinical Trials Registry: NCT03380754. (Copyright © 2022 by the American Academy of Orthopaedic Surgeons.) |
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| سلسلة جزيئية: | ClinicalTrials.gov NCT03380754 |
| المشرفين على المادة: | 0 (Carbohydrates) |
| تواريخ الأحداث: | Date Created: 20220321 Date Completed: 20220524 Latest Revision: 20220524 |
| رمز التحديث: | 20231215 |
| DOI: | 10.5435/JAAOS-D-21-00960 |
| PMID: | 35312650 |
| قاعدة البيانات: | MEDLINE |
Full Text Finder | تدمد: | 1940-5480 |
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| DOI: | 10.5435/JAAOS-D-21-00960 |