The Effect of Preoperative Oral Intake of Liquid Carbohydrate on Postoperative Stress Parameters in Patients Undergoing Laparoscopic Cholecystectomy: An Experimental Study.

PURPOSE: The aim of this study is to investigate the effects of preoperative oral intake of liquid carbohydrate on postoperative stress parameters (blood glucose, insulin resistance, cortisol, noradrenaline, and adrenaline levels) in patients who underwent laparoscopic cholecystectomy. DESIGN: This is an experimental study with intervention and control groups. METHODS: The sample consisted of 68 patients who underwent laparoscopic cholecystectomy (control group = 33; intervention group = 35). Twelve-hour preoperative fasting was applied to the patients in the control group in accordance with the clinical routine. Clear oral liquid carbohydrate (400 mL; 12.5 g/100 mL maltodextrin, 50 kcal/100 mL, pH 5.0) was administered to the patients in the intervention group at the preoperative second hour. Blood samples were taken from the patients at the preoperative 2nd and postoperative 2nd and 24th hours, and their blood glucose, insulin resistance, cortisol, noradrenaline, and adrenaline levels were measured. RESULTS: Preoperative oral intake of carbohydrate had no effect on blood glucose (P > .05) but decreased insulin resistance at the postoperative 24th hour (P = .044; intervention and control group: 3.62 ± 3.44 to 8.16 ± 12.57 respectively) and cortisol level at the postoperative 2nd hour (P = .005; intervention and control group: 15.16 ± 6.53 mg/dl to 20.14 ± 7.49 mg/dl, respectively). In all of the three measurements, we found that the noradrenaline level of the patients in the intervention group was higher than the value of those in the control group (319.80 ± 301.49 pg/mL to 211.65 ± 141.11 pg/mL [P = .450]; 361.40 ± 213.50 pg/mL to 216.13 ± 114.53 [P = .001]; 268.40 ± 164.04 pg/mL to 196.00 ± 83.33 pg/mL [P = .026], respectively). Preoperative oral intake of liquid carbohydrate had no effect on postoperative adrenaline level (P > .05). CONCLUSIONS: Oral intake of liquid carbohydrate given at the preoperative 2nd hour decreased postoperative stress response through insulin resistance and cortisol.

Intraocular pressure changes: the McGrath video laryngoscope vs the Macintosh laryngoscope; a randomized trial.

STUDY OBJECTIVE: To determine the effects of the McGrath Series 5 video laryngoscope on intraocular pressure (IOP) during laryngoscopy. DESIGN: Prospective, randomized, double blind. SETTING: Operating room. PATIENTS: Eighty adult patients of American Society of Anesthesiologist physical status 1 scheduled for nonophthalmic elective surgery under general anesthesia. INTERVENTIONS: The endotracheal intubation was provided using McGrath series 5 video laryngoscope in MG group (n=40) or Macintosh laryngoscope in M group (n=40). MEASUREMENTS: The IOP of the right and left eyes was measured before and after the laryngoscopic process. MAIN RESULTS: The mean arterial blood pressure values just before laryngoscopy and intubation and after intubation were 77.38±6.18 and 97.38±12.77 in the McGrath video laryngoscope group and 75.85±7.88 and 99.12±14.30 in the Macintosh laryngoscope group, respectively. The IOP values of the left eye after intubation and at the 5th and the 10th minutes in the Macintosh laryngoscope group were found to be significantly higher than those in the McGrath video laryngoscope group (P=.019, P=.019, and P=.007, respectively). In addition, the IOP values of the right eye were found to be higher after intubation and at the 5th and the 10th minutes in the Macintosh laryngoscope group, compared to the McGrath video laryngoscope group (P=.009, P=.021, and P=.011, respectively). The mean IOP values for the left eye just before laryngoscopy and intubation and after intubation were 10.65±2.52 and 15.57±3.62 in the McGrath video laryngoscope group, and for the right eye, they were 10.60±1.64 and 17.17±2.38 in the Macintosh laryngoscope group, respectively. CONCLUSION: The McGrath Series 5 video laryngoscope may provide a lower IOP level compared to the Macintosh laryngoscope in an otherwise healthy, young patient population.

Factors associated with the pain catastrophizing scale and validation in a sample of the Turkish population.

AIM: The aim of this study was to validate the Pain Catastrophizing Scale (PCS) in the Turkish population and to investigate its correlation with the demographic and clinical characteristics of patients. MATERIALS AND METHODS: Volunteer patients, who were scheduled for elective surgery and who applied to the Outpatient Clinic of Anesthesiology for preoperative evaluation, were asked to complete a PCS form. The patient's age, sex, educational level, marital status, presence of chronic pain, and American Society of Anesthesiologists score were recorded, and PCS scores and demographic variables were compared statistically. RESULTS: Of the 257 patients enrolled in the study, 136 were male, 121 female, and the median age was 40. The 3 subscales in the Turkish version of the PCS consisted of rumination, magnification, and helplessness. Internal consistency of PCS was found to be congruent with Cronbach's alpha = 0.90. Significantly higher PCS scores were found in women with chronic pain. In addition, patients who graduated from primary school had statistically higher scores compared to those who graduated from high school. CONCLUSION: In accordance with the original scale, demographic specifications of the Turkish version of the PCS were found congruent. PCS scores in our population were found compatible with the literature review.