Comparison Of The Effects Of Preoperative Oral Administration Of Different Clear Drinks On Perioperative Period Of Colorectal Cancer

Background And PurposesPreoperative oral administration of appropriate amount of clear drinks has become one of the important measures to the concept of ERAS(enhanced recovery after surgery),but the clinical implementation is not standardized.To explore and compare the effects of preoperative oral administration of different common clear drinks on the perioperative period of laparoscopic colorectal cancer,to provide some clinical guidance and theoretical basis for standardizing the selection of clear drinks before operation,and to promote its further promotion and application in clinic.MethodsAccording to the inclusion and exclusion criteria,a total of 60 patients with colorectal cancer were included in the study.The subjects were randomly divided into 4 groups:group A(warm boiled water group),group B(pulsating drink group),group C(10%glucose group)and group D(Junbei’an nutrient solution group)with 15 cases in each group.All patients were required to take oral 600ml clear drinks at 22:00 one night before operation,300ml 3 hours before operation,and drink up within half an hour.Except for the different clear drinks consumed before operation in each group,other perioperative management measures were carried out according to the ERAS’s plan of our department,and the operations were carried out by the same group of doctors,and the operation table was thefirst.No sugary liquid was infused during the operation.The general clinical data of patients in each group before,during and after operation were recorded.The subjective comfort(including five feelings of thirst,hunger,anxiety,nausea and fatigue)was measured 3 hours before operation and 0.5 hours before operation by visual analogue scale(VAS).Blood glucose(FBG),serum insulin(FIN)and C-reactive protein were measured 3 hours before operation,the first day and the third day at 6:00 a.m.after operation,end of operation,respectively.The corresponding insulin resistance index(HOMA-IR)was calculated according to the Homeostasis model evaluation formula HOMA-IR=FIN(mU/L)× FBG(mmol/L)/22.5.The differences among groups were analyzed and compared by SPSS20.0 software.Results1.The general clinical data of patients in each group before,during and after operation,there was no significant difference between the two groups(p>0.05).2.Compared with 3 hours before operation,each group could reduce the feeling of thirst 0.5 h before operation(p<0.05).Compared with group A and B,group C and D could reduce the feeling of hunger at 3 h and 0.5 h before operation(p<0.05),but there was no significant difference in anxiety,nausea and fatigue among the three groups(p>0.05).3.At the end of operation,the blood glucose of each group was higher than that before operation,but the increase of blood glucose in group A was larger than that in the other three groups(p<0.05),and the comparison between groups was also statistically significant(p<0.05).At the end of operation,the concentration of serum insulin in each group increased in varying degrees,but the increase in group A was greater than that in the other three groups(p<0.05).And the concentration of serum insulin in group A was significantly higher than that in the other three groups at the end of operation,the first day after operation and the third day after operation(p<0.05),the level of serum insulin on the 3rd day after operation in group A was still significantly higher than that at 3 hours before operation(p<0.05).Although the postoperative insulin concentration in group B,C and D was higher than that before operation,it tended to be more stable than that in group A.The change trend of perioperative HOMA-IR index in each group was similar to that of serum insulin.At the same time,there was no significant difference in the level of C-reactiveprotein between the two groups(p>0.05),but it was significantly higher on the 1st and 3rd day after operation than that before operation(p<0.05).Conclusions1.Oral administration of different clear drinks(warm water,pulsating beverage,10%GS,Junbei’an nutrient solution)could reduce the preoperative thirst,but had no significant effect on anxiety,nausea and tiredness.oral warm boiled water could not reduce preoperative hunger,oral 10%GS and Junbeian nutrient solution could reduce preoperative hunger,and oral pulse could also improve preoperative hunger and discomfort,but the effect was not as obvious as the former two.It is suggested that the improvement of hunger may be related to the sugar content of clear drinks.2.Compared with oral warm boiled water before operation,oral sugar-containing clear drinks before operation can reduce the fluctuation of blood glucose and serum insulin after operation,and reduce the degree of insulin resistance after operation,but there is no significant difference among different drinks containing sugar.3.Compared with oral warm boiled water before operation,oral sugar-containing clear drink,especially Junbeian nutrient solution,did not achieve the desired effect in promoting the recovery of intestinal peristalsis after operation.