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.
Study Type
OBSERVATIONAL
Enrollment
53
Administration of carbohydrate fluid
Seoul National University Bundang Hospital
Seongnam-si, Gyeonggi-do, South Korea
RECRUITINGLevel of stress hormone 1
Stress hormone (interleukin-1β, interleukin-6, interleukin-10, and tumor necrosis factor-α) measured after induction of spinal anesthesia
Time frame: After induction of spinal anesthesia at first stage total knee arthroplasty/ an average 10 minutes
Level of stress hormone 2
Stress hormone (interleukin-1β, interleukin-6, interleukin-10, and tumor necrosis factor-α) measured after induction of spinal anesthesia
Time frame: After induction of spinal anesthesia at second stage total knee arthroplasty/ an average 10 minutes
Gastric volume 1
Gastric volume measured before induction of spinal anesthesia using ultrasound
Time frame: First stage operation, during the gastric volume measuring at preoperative holding area/ an average of 30 minutes
Gastric volume 2
Gastric volume measured before induction of spinal anesthesia using ultrasound
Time frame: Second stage operation, during the gastric volume measuring at preoperative holding area/ an average of 30 minutes
Anxiety scale 1
Anxiety scale measured before surgery
Time frame: First stage operation, one day before surgery/ an average of 30 minutes
Anxiety scale 2
Anxiety scale measured before surgery
Time frame: Second stage operation, one day before surgery/ an average of 30 minutes
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