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BACKGROUND: Enhanced recovery after surgery advocates that consuming carbohydrates two hours before anesthesia is beneficial to the patient's recovery. Patients with diabetes are prone to delayed gastric emptying. Different guidelines for preoperative carbohydrate consumption in patients with diabetes remain controversial due to concerns about the risk of regurgitation, aspiration and hyperglycemia. Ultrasonic gastric volume (GV) assessment and blood glucose monitoring can comprehensively evaluate the safety and feasibility of preoperative carbohydrate intake in type 2 diabetes (T2D) patients. AIM: To evaluate the impact of preoperative carbohydrate loading on GV before anesthesia induction in T2D patients. METHODS: Patients with T2D receiving surgery under general anesthesia from December 2019 to December 2020 were included. A total of 78 patients were randomly allocated to 4 groups receiving 0, 100, 200, or 300 mL of carbohydrate loading 2 h before anesthesia induction. Gastric volume per unit weight (GV/W), Perlas grade, changes in blood glucose level, and risk of reflux and aspiration were evaluated before anesthesia induction. RESULTS: No significant difference was found in GV/W among the groups before anesthesia induction (P > 0.05). The number of patients with Perlas grade II and GV/W > 1.5 mL/kg did not differ among the groups (P > 0.05). Blood glucose level increased by > 2 mmol/L in patients receiving 300 mL carbohydrate drink, which was significantly higher than that in groups 1 and 2 (P < 0.05). CONCLUSION: Preoperative carbohydrate loading < 300 mL 2 h before induction of anesthesia in patients with T2D did not affect GV or increase the risk of reflux and aspiration. Blood glucose levels did not change significantly with preoperative carbohydrate loading of < 200 mL. However, 300 mL carbohydrate loading may increase blood glucose levels in patients with T2D before induction of anesthesia.
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OBJECTIVE: To compare and improve the methods of establishing animal model of experimental chronic sinusitis in rabbits . METHODS: Sixty-six New Zealand white rabbits were divided into seven groups: control group, sham-operation group I, sham-operation group II, bacteria inoculation group, ostia-blocked group, ostia-blocked and bacteria inoculation group, incomplete ostium blocked and set-cotton group. The animals were examined by the methods of histology and bacteriology after 42 days. RESULTS: The positive rate of chronic inflammation in ostium blocked group was 80%, inoculated staphylococcus group was 100%, incomplete ostium blocked and set-cotton group was 100%, and the other groups were 0%. All infected sinuses displayed signs of moderate or severe chronic inflammation. The cultivated bacteria were mainly opportunistic pathogens. The probability of having abscess in maxillary sinus was high in ostia-blocked and bacteria inoculation group. CONCLUSIONS: The method of incomplete ostium blockage and set cotton can establish stable chronic sinusitis model, it is a simple and perfect method.
Assuntos
Modelos Animais de Doenças , Sinusite , Animais , Doença Crônica , Coelhos , Sinusite/microbiologiaRESUMO
OBJECTIVE: To evaluate some perplexing problems in the diagnosis and treatment of juvenil recurrent laryngeal papillomatosis (JRLP) and the relationship between juvenile onset recurrent respiratory papillomatosis(JORRP) and infantile laryngeal condyloma accuminatum (ILCA). METHODS: A group of 44 cases with JRLP were analyzed retrospectively from March, 1994 to March, 2002 in the light of literature review. RESULTS: The average age of first visit was 1.6 years. Average 5.3 operations had been performed per patient. There was an interval of average 2.4 months between two surgical excisions. Of 233 operations, the total incidence rate of all the complications was 3.9%. At present, the laryngeal lesion of 18 cases have withered away for over 1 year. 11 cases have being followed up. 10 cases have lost follow-up and 5 cases have died (11.4%). Combined laryngeal lesion excision with tracheotomy aiming at prolonging operative interval or Chinese traditional medicine has received more satisfactory effect than other therapies. There is an extensive similarity between JORRP and ILCA. CONCLUSIONS: To demondrate further whether JORRP and ILCA are the same identical disease has important significance in both theoretical study and clinic practice. The treatment for JRLP is still difficult. The tracheotomy for laryngeal obstruction resulted from the laryngeal lesion of JRLP should be avoided as far as possible. Combined laryngeal lesion excision with tracheotomy aiming at prolonging opertive interval or Chinese traditional medicine shows optimistic prospect.
