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Evidence-based Practice and Quality Improvement

Does quality of recovery improve by preoperative oral carbohydrate?

1AP8-7

Asakura, A.; Goto, T.

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European Journal of Anaesthesiology (EJA): June 2013 - Volume 30 - Issue - p 29-29
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Background and Goal of Study: Preoperative oral carbohydrate (CHO) has been shown to reduce postoperative discomfort and postoperative hospital stay. It is unknown whether preoperative CHO also improves postoperative quality of recovery (QoR) after anesthesia. To improve QoR is important in the light of improving patients' quality of life. In this study, we evaluated the effect of preoperative CHO on patients' recovery using the Quality of Recovery 40 (QoR-40) Japanese version questionnaire.

Materials and Methods: The study was prospective, randomized, controlled clinical trial. ASA physical status 1 and 2, 20 to 79 year-old patients undergoing the surgery of body surface were enrolled. Patients with impaired gastrointestinal motility, poor Japanese comprehension, or psychiatric disturbance were excluded. Subjects were randomized into one of three groups. Arginaid Water (AW) group received 250ml of AW at 6.00 hours on the morning of surgery. OS-1 group received 1000ml of OS-1 from 20.00 hours on the night before surgery till 2 hours before anesthesia. Control group were fasted from midnight. The primary outcome was the QoR-40 at 24 hours after surgical procedure. Data was analyzed using Kruskal-Wallis Test.

Results and Discussion: 96 subjects were randomized, and 86 completed the study. Patients' baseline characteristics were not different among groups (Table 1).

The median (interquartile range) for the QoR-40 score after the surgery was 188 (175-195), 189 (162.25-196), and 182 (165-193) for the AW group, OS-1 group, and control group, respectively (p=0.5662). A sample size of 188 subjects per group was estimated to achieve 80% power to detect a 7-point difference in the aggregated QoR-40 score for the 3 study groups to be compared assuming an overall standard deviation of 21. The results showed no statistical difference, and to detect this difference, a huge number of subjects will be necessary.

Conclusion: A preoperative CHO has little improvement on quality of recovery in less-invasive surgery.

© 2013 European Society of Anaesthesiology