Arthritis Knee
Conditions
Brief summary
In our institution, many patients undergo staged bilateral total knee arthroplasty at weekly intervals, and most of the patients are older adults with degenerative arthritis. As recommended, the older adult patients who undergoing total knee arthroplasty drink carbohydrate-containing fluid (400 ml) 2 hours prior to surgery. In this type of surgery, there are additional points to consider when applying the fasting guidelines. This is because, in addition to the factor of advanced age, which can affect gastric emptying time, the patient's physical, medical, and psychological conditions at the first and the second operation may be different. For example, the effect of the acute pain that occurs after the first total knee arthroplasty and subsequent opioids administered on gastric motility cannot be ignored. However, to date, there have been no studies examining the association of stress (emotional and surgical) and residual gastric volume of older adult patients with staged bilateral total knee arthroplasty and whether there is a difference according to the stage when carbohydrate-containing fluid is ingested. In the present study, the investigators will evaluate the effect of emotional stress, surgical stress, pain, and the use of opioids on the residual gastric volume in older adults undergoing staged-bilateral total knee arthroplasty.
Interventions
DIETARY_SUPPLEMENTCarbohydrate drinking
Administration of carbohydrate fluid
Sponsors
Seoul National University Bundang Hospital
Study design
Observational model
CASE_ONLY
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
65 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Patients scheduled for staged bilateral total knee arthroplasty aged ≥ 65 * American Society of Anesthesiologists physical status classification 1, 2, and 3 * Body mass index \< 35 kg/cm2 * Patients administered carbohydrate-containing fluid 2 hours prior to surgery
Exclusion criteria
* Previous surgery of the upper gastrointestinal tract * Achalasia * Diabetes
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Level of stress hormone 1 | After induction of spinal anesthesia at first stage total knee arthroplasty/ an average 10 minutes | Stress hormone (interleukin-1β, interleukin-6, interleukin-10, and tumor necrosis factor-α) measured after induction of spinal anesthesia |
| Level of stress hormone 2 | After induction of spinal anesthesia at second stage total knee arthroplasty/ an average 10 minutes | Stress hormone (interleukin-1β, interleukin-6, interleukin-10, and tumor necrosis factor-α) measured after induction of spinal anesthesia |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Gastric volume 1 | First stage operation, during the gastric volume measuring at preoperative holding area/ an average of 30 minutes | Gastric volume measured before induction of spinal anesthesia using ultrasound |
| Gastric volume 2 | Second stage operation, during the gastric volume measuring at preoperative holding area/ an average of 30 minutes | Gastric volume measured before induction of spinal anesthesia using ultrasound |
| Anxiety scale 1 | First stage operation, one day before surgery/ an average of 30 minutes | Anxiety scale measured before surgery |
| Anxiety scale 2 | Second stage operation, one day before surgery/ an average of 30 minutes | Anxiety scale measured before surgery |
Countries
South Korea
Contacts
Primary ContactHyun-Jung Shin, MD., PhD.
Outcome results
None listed