Postoperative cognitive dysfunction (POCD) is more common in older patients, and increased insulin resistance is an important factor for POCD. Fasting before surgery is performed to reduce the incidence of pulmonary aspiration after anesthesia. However, prolonged fasting increases insulin resistance. Recently, it is recommended to minimize fasting times and consume carbohydrate drinks before surgery. Therefore, the investigators investigate whether preoperative carbohydrate drinks can reduce insulin resistance in the elderly patients. Fifty patients (age\>65 years) scheduled for arthroplasty will be divided into carbohydrate (n=28) and control (n=28) groups. Randomly selected patients of the carbohydrate group are given 400ml of 12.8 g/100 ml carbohydrate beverage 2-3 hours before their scheduled operation. In contrast, patients in the control group are fasted from water 2 h before surgery according to standard protocol.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
PREVENTION
Masking
DOUBLE
Enrollment
56
Randomly selected patients of the carbohydrate group are given oral carbohydrate (400ml) 2-3 hours before surgery. In contrast, patients in the control group are fasted water 2 hours before surgery according to the standard protocol.
Department of Anesthesiology and Pain Medicine , Anesthesia and Pain Research Institute, Yonsei University College of Medicine
Seoul, South Korea
Insulin resistance
Insulin resistance index = glucose x insulin/22.5
Time frame: Before anesthesia
Insulin resistance
Insulin resistance index = glucose x insulin/22.5
Time frame: 1 hour after surgery
glycemic variability
Coefficient of glucose variability =SD/mean x 100 (%)
Time frame: Before anesthesia
glycemic variability
Coefficient of glucose variability =SD/mean x 100 (%)
Time frame: 5 minutes after anesthesia
glycemic variability
Coefficient of glucose variability =SD/mean x 100 (%)
Time frame: 1 hour after surgery
glycemic variability
Coefficient of glucose variability =SD/mean x 100 (%)
Time frame: 10 minutes after admission of recovery room
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