PMID- 32433428
OWN - NLM
STAT- MEDLINE
DCOM- 20210728
LR  - 20210728
IS  - 1940-5480 (Electronic)
IS  - 1067-151X (Linking)
VI  - 29
IP  - 1
DP  - 2021 Jan 1
TI  - Preoperative Carbohydrate Drinks Do Not Decrease Postoperative Nausea and 
      Vomiting in Type 2 Diabetic Patients Undergoing Total Knee Arthroplasty-A 
      Randomized Controlled Trial.
PG  - 35-43
LID - 10.5435/JAAOS-D-20-00089 [doi]
AB  - INTRODUCTION: We evaluated whether preoperative carbohydrate drink would be able 
      to decrease postoperative nausea and vomiting (PONV) and improve the quality of 
      recovery (QoR) in diabetic patients undergoing total knee arthroplasty (TKA). 
      METHODS: Eighty-two patients were randomized to either the intravenous (IV) 
      Dextrose group (n = 41) or Oral carbohydrate (CHO) group (n = 41). The IV 
      Dextrose group received dextrose solution mixed with insulin while fasting, and 
      the Oral CHO group received carbohydrate drinks preoperatively. PONV was assessed 
      up to postoperative 36 hours, and QoR was assessed before surgery and on 
      postoperative day (POD) 1. Blood glucose was measured from the morning of surgery 
      until POD 1. RESULTS: PONV scores were not different between the groups. 
      Postoperative QoR scores were significantly higher in the Oral CHO group (median 
      [interquartile range]; 160 [153 to 167]) than the IV Dextrose group (155 [147 to 
      159]) (P = 0.009), but the difference did not meet the minimal clinically 
      important difference. Blood glucose was comparable between the groups. 
      DISCUSSION: Preoperative CHO drink did not reduce PONV in diabetic patients after 
      total knee arthroplasty. A statistically significant but clinically questionable 
      improvement in the QoR was seen in the Oral CHO group. However, preoperative CHO 
      drink did not increase hyperglycemia, which suggests that it may be a safe 
      component of perioperative care in diabetic patients.
CI  - Copyright (c) 2020 by the American Academy of Orthopaedic Surgeons.
FAU - Shin, Seokyung
AU  - Shin S
AUID- ORCID: 0000-0002-2641-0070
AD  - From the Department of Anesthesiology and Pain Medicine (Dr. Seokyung Shin, Dr. 
      Choi, Dr. Kang, and Dr. Kim), the Anesthesia and Pain Research Institute (Dr. 
      Seokyung Shin, Dr. Choi, Dr. Kang, and Dr. Kim), Yonsei University College of 
      Medicine, the Department of Research Affairs (Dr. Hyejung Shin), Biostatistics 
      Collaboration Unit, Yonsei University College of Medicine, and the Department of 
      Orthopedic Surgery (Dr. Yang, Dr. Park, and Dr. Kwon), Yonsei University College 
      of Medicine, Seoul, Korea.
FAU - Choi, Yong Seon
AU  - Choi YS
FAU - Shin, Hyejung
AU  - Shin H
AUID- ORCID: 0000-0001-5346-7278
FAU - Yang, Ick Hwan
AU  - Yang IH
FAU - Park, Kwan Kyu
AU  - Park KK
FAU - Kwon, Hyuck Min
AU  - Kwon HM
FAU - Kang, Byunghag
AU  - Kang B
FAU - Kim, So Yeon
AU  - Kim SY
AUID- ORCID: 0000-0001-5352-157
LA  - eng
SI  - ClinicalTrials.gov/NCT02432781
PT  - Journal Article
PT  - Randomized Controlled Trial
PL  - United States
TA  - J Am Acad Orthop Surg
JT  - The Journal of the American Academy of Orthopaedic Surgeons
JID - 9417468
RN  - 0 (Blood Glucose)
SB  - IM
MH  - *Arthroplasty, Replacement, Knee/adverse effects
MH  - Blood Glucose
MH  - *Diabetes Mellitus, Type 2/complications
MH  - Humans
MH  - Perioperative Care
MH  - Postoperative Nausea and Vomiting/etiology/prevention & control
MH  - Preoperative Care
EDAT- 2020/05/21 06:00
MHDA- 2021/07/29 06:00
CRDT- 2020/05/21 06:00
PHST- 2020/02/07 00:00 [received]
PHST- 2020/04/06 00:00 [accepted]
PHST- 2020/05/21 06:00 [pubmed]
PHST- 2021/07/29 06:00 [medline]
PHST- 2020/05/21 06:00 [entrez]
AID - 00124635-202101010-00005 [pii]
AID - 10.5435/JAAOS-D-20-00089 [doi]
PST - ppublish
SO  - J Am Acad Orthop Surg. 2021 Jan 1;29(1):35-43. doi: 10.5435/JAAOS-D-20-00089.