Rozhledy v chirurgii : měsíčník Československé chirurgické společnosti
-
Controlled Clinical Trial
[Preparation of patients for operation with per-oral intake on the day of the planned surgery].
The clinical studies carried out leads to the hypothesis that the starvation of patients for several hours prior to a surgical procedure has a negative influence on the internal metabolic environment of a patient. It also has an impact on the psychosomatic disposition of the patient's physiology of metabolic processes and the proper functioning of vital organs and systems. This hypothesis was already stated by doctors specialized in Intensive Care Units in other European countries. In the frame of methodology, ERAS (enhancement recovery after surgery) also known as fast track, solves this problem not only on the level of clinical studies but also clinical practice. METHODOLOGY AND GROUP OF PATIENTS: The group of patients selected had been surgically treated for disease of the colon (both benign and malignant) and were divided into 3 groups: A--basically starving from mid-night of the day of operation, B--patients secured the night before the operation and on the day of the operation by a parenteral intake of 10% glucose solution with minerals, C--patients drinking a special drink, consisting basically of sugars (mainly maltodextrin) mixed in with minerals, the evening before the operation and on the day of the operation. Patients used in this study were required to fulfill several criteria to be included into the study: these criteria consisted of a co-morbidity of ASA 1-2, weight 60-90 kg, age 35-75 years, operating time of the procedure on the colon of 120 +/- 30 min. without complications. These patients also had not been given any transfusions of red blood cells or blood derivatives during or after the surgery (or during the time of hospitalization etc). The selected biochemical markers, muscular power, some cardial function, and subjective patients feelings were monitored in all patients during perioperative period. The basic statistical methods were used for evaluation of current results. ⋯ Till date the findings documented by monitored indicators may prove that the implementation of per-oral intake on the day of an surgery will benefit and improve the quality of care of surgically treated patients and increase the number of successful operations.