The impact of preoperative carbohydrate ingestion one hour before surgery on children's preoperative anxiety and postoperative pain under ultrasound monitoring: A randomized controlled trial.

OBJECTIVE: To investigate the effects of oral carbohydrates 1 h before surgery on preoperative anxiety and postoperative pain in children with obstructive sleep apnea hypopnea syndrome (OSAHS) under gastric ultrasound monitoring.

METHODS: Children with obstructive sleep apnea hypopnea syndrome (OSAHS) who visited the Department of Otorhinolaryngology and Head and Neck Surgery at Changzhi People's Hospital Affiliated to Changzhi Medical College for adenotonsillectomy from June to August 2024 were selected and randomly divided into Control group (C group) and Experiment group (E group). The Experiment group orally ingested 5 ml/kg of carbohydrates 1 h before surgery, while the control group followed the routine preoperative fasting protocol of 6 h without food and 2 h without fluids. The gastric antrum dimensions in the cephalocaudal direction (D1) and anteroposterior direction (D2) in the right lateral position of children in Group E were measured by ultrasound immediately after drinking, 30 min before entering the operating room, and just before entering the operating room, and the cross-sectional area of the gastric antrum (CSA), gastric volume (GV), and gastric volume per unit body weight (GV/W) were calculated using the formula, then compared with the gastric volumes of children in the control group at the same time points to assess the risk of reflux and aspiration. Used the Modified Yale Preoperative Anxiety Scale and the Wong-Baker FACES Rating Scale to assess the preoperative anxiety levels and postoperative pain intensities of children in the two groups and compared the scores. Simultaneously, measured and compared the fasting blood glucose, blood insulin levels, and insulin resistance indices in the perioperative period of the two groups of children, and recorded the incidence rates of preoperative crying, intraoperative reflux and aspiration, postoperative nausea and vomiting, agitation, and somnolence in both groups.

RESULTS: After ingesting carbohydrates, the CSA and GV in children in Group E were significantly higher than those in Group C (P < 0.05), but no significant gastric content was detected in the gastric antrum of children in either group before entering the operating room (P > 0.05). The fasting blood glucose, blood insulin levels, and insulin resistance index in Group E were all significantly lower than those in Group C (P < 0.05). Moreover, the preoperative anxiety level in Group E, as well as the incidence rates of postoperative nausea and vomiting and agitation, were all significantly lower than those in Group C (P < 0.05), but there was no significant difference in postoperative pain scores between the two groups (P > 0.05).

CONCLUSION: Oral intake of 5 ml/kg of carbohydrates 1 h before surgery is safe, it can significantly improve preoperative anxiety and blood glucose fluctuations in children and reduce the incidence of perioperative adverse reactions, but it does not significantly improve postoperative pain.