None listed
Conditions
Brief summary
As an essential aspect of enhanced recovery after surgery, the advantages of preoperative oral carbohydrate loading (eg, improving patients' comfort during preoperative preparation, reducing nausea and vomiting, and reducing insulin resistance) have been shown by many studies. We hypothesized that in elderly patients undergoing total knee replacement surgery, preoperative oral carbohydrate loading would reduce the incidence of postoperative delirium and improve patient recovery.
Interventions
The intervention group will begin a fasting regime the day before surgery which will involve cessation of solid foods at 2000 hours and cessation of fluids at 2200hrs. All patients will be registered on the morning surgery list. All patients will be overseeing adherence to the fasting regime ward nurse. Strategies used to monitor adherence to the intervention include regular observation. This must be finished by 2200 hours and nursing staff will monitor fluid input. The intervention group will
The intervention group will begin a fasting regime the day before surgery which will involve cessation of solid foods at 2000 hours and cessation of fluids at 2200hrs. All patients will be registered on the morning surgery list. All patients will be overseeing adherence to the fasting regime ward nurse. Strategies used to monitor adherence to the intervention include regular observation. This must be finished by 2200 hours and nursing staff will monitor fluid input. The intervention group will consume 300 ml liquid carbohydrates (100 ml solution includes 22.5 maltodextrin and 2.5 g glucose) up to three hours before surgery and will be monitored by nurses. The duration of time that participants will have to consume the liquid carbohydrates 10 minutes window.
Sponsors
Karaman Training and Research Hospital
Study design
Allocation
Randomised controlled trial
Intervention model
Parallel
Primary purpose
Treatment
Masking
Blinded (masking used) (Subject, Caregiver, Investigator, Outcomes Assessor)
Eligibility
Sex/Gender
All
Age
65 Years to 85 Years
Healthy volunteers
No
Inclusion criteria
Physical status according to the American Society of Anesthesiologists (ASA) II-III Patients scheduled for total knee arthroplasty
Exclusion criteria
Previous operation on the same knee Hepatic or renal insufficiency Younger than 65 years old Patients undergoing general anesthesia Allergy or intolerance to one of the study medications ASA IV Chronic gabapentin/pregabalin use (regular use for longer than 3 months) Chronic opioid use (taking opioids for longer than 3 months, or daily oral morphine equivalent of >5mg/day for one month) impaired gastrointestinal motility Fasting glucose >200 Acquired immunodeficiency Severe malnutrition
Outcome results
None listed