ผลของการให้คาร์โบไฮเดรตก่อนการผ่าตัดต่อการตอบสนองทางเมตาบอลิซึมและการอักเสบภายหลังการศัลยกรรมจัดกระดูกขากรรไกร: การศึกษาแบบสุ่มและมีกลุ่มควบคุม

Abstract

Introduction: Enhanced recovery after surgery (ERAS) is currently adopted in surgery, preoperative carbohydrate loading can improve metabolic and inflammatory response. This study aimed to investigate the effects of preoperative carbohydrate loading on interleukin-6 (IL-6) and insulin resistance (HOMA-IR index) in orthognathic surgery. Patients and methods: This study was a randomized clinical trial. Twenty patients were evenly randomized to either recieve 400 mL of an oral carbohydrate drinking (CHO group) or 400 mL drinking water (placebo group) 3 hours before surgery. IL-6 levels and insulin resistance were analysed at baseline ( TO) and 24 hours after surgery (T1) by Enzyme-linked immunosorbent assay (ELISA). Postoperative outcomes and quality of postoperative recovery were also documented. Results: IL-6 levels and insulin resistance did not differ significantly between CHO and placebo groups (CHO group: 6.89 pg/mL of IL-6 levels and 5.5 of HOMA-IR, placebo group: 6.64 pg/mL of IL-6 levels and 4 of HOMA-IR). In addition, CHO group showed significantly lesser length of time in recovery room, compared to placebo group (CHO group: 48 + 15.49 mins and placebo group: 63 + 9.48 mins, P <0.05). No significant differences of length of time in hospital stay and quality of recovery were observed. Conclusion: Preoperative carbohydrate loading (glucose 50 g of 400 mL) in orthognathic surgery was safe and decrease length of time in recovery room. However, preoperative carbokydrate loading in orthognathic surgery did not improve metabolic and inflammatory response including postoperative recovery.