Preoperative carbohydrate fluid intake reduces postoperative nausea and vomiting without increasing gastric volume in neuroendoscopic sellar tumor surgery

术前摄入碳水化合物液体可减少神经内镜下鞍区肿瘤手术后的恶心呕吐,且不会增加胃容量。

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Abstract

PURPOSE: This study evaluated the effect of preoperative carbohydrate fluid intake on gastric volume (GV), blood glucose (BG), reflux aspiration, and postoperative nausea and vomiting (PONV) in patients with sellar tumors undergoing neuroendoscopic transnasal-sphenoidal sinus resection (NTSR). METHODS: Fifty-eight patients scheduled for elective NTSR were randomly assigned to Group A (n = 29), who received 400 mL of 10% glucose solution orally 2 h before anesthesia, or Group B (n = 29), who fasted for at least 8 h. Gastric ultrasound was used to measure antral diameters before induction and after surgery, from which GV was estimated. BG levels were recorded at fasting (T1), before induction (T2), and after surgery (T3). The incidence of PONV within 24 h, reflux aspiration, and hospital stay duration were also assessed. RESULTS: In Group A, the mean GV decreased significantly from 47.81 ± 2.45 mL before induction to 45.71 ± 2.08 mL after surgery (p < 0.05), while no significant change was observed in Group B. Before induction, GV was higher in Group A than in Group B (p < 0.05). No patients experienced reflux aspiration in either group. The incidence of PONV was significantly lower in Group A (23.1%, 6/26) than in Group B (65.4%, 17/26; p < 0.05). BG levels at all time points showed no significant intergroup differences. CONCLUSIONS: Carbohydrate fluids taken 2 h before anesthesia do not increase GV or aspiration risk but reduce PONV in NTSR patients without affecting BG levels.

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