Effect of preoperative oral carbohydrate on overweight or obese patients undergoing laparoscopic hysterectomy in Trendelenburg position

WEI Guang-le; LU Rong-xiang; QIU Jing-hui; CHEN Chang; DAI Ti-jun

doi:10.11659/jjssx.01E025030

您当前的位置：

首页 >

文章列表页 >

Effect of preoperative oral carbohydrate on overweight or obese patients undergoing laparoscopic hysterectomy in Trendelenburg position

Clinical Research | 更新时间：2025-11-25

- Effect of preoperative oral carbohydrate on overweight or obese patients undergoing laparoscopic hysterectomy in Trendelenburg position
- JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY Vol. 34, Issue 11, Pages: 1004-1007(2025)
- 作者机构：
  
  1.盐城市第三人民医院麻醉科，江苏盐城 224000
  2.徐州医科大学麻醉药理学教研室，江苏徐州 221004
- 作者简介：
- 基金信息：
- DOI：10.11659/jjssx.01E025030
  CLC： R713.4+2
- Received：07 January 2025，
  
  Published：25 November 2025
- 稿件说明：
移动端阅览
韦广乐,陆容祥,仇晶辉等.术前口服碳水化合物对超重或肥胖患者Trendelenburg体位行腹腔镜子宫切除的影响[J].局解手术学杂志,2025,34(11):1004-1007.

WEI Guang-le,LU Rong-xiang,QIU Jing-hui,et al.Effect of preoperative oral carbohydrate on overweight or obese patients undergoing laparoscopic hysterectomy in Trendelenburg position[J].JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY,2025,34(11):1004-1007.
韦广乐,陆容祥,仇晶辉等.术前口服碳水化合物对超重或肥胖患者Trendelenburg体位行腹腔镜子宫切除的影响[J].局解手术学杂志,2025,34(11):1004-1007. DOI： 10.11659/jjssx.01E025030.

WEI Guang-le,LU Rong-xiang,QIU Jing-hui,et al.Effect of preoperative oral carbohydrate on overweight or obese patients undergoing laparoscopic hysterectomy in Trendelenburg position[J].JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY,2025,34(11):1004-1007. DOI： 10.11659/jjssx.01E025030.

摘要

目的

明确术前口服碳水化合物对超重或肥胖患者Trendelenburg体位行腹腔镜子宫切除的影响。

方法

选择2022年9月至2024年8月于盐城市第三人民医院以Trendelenburg体位行腹腔镜子宫切除的超重或肥胖患者72例为研究对象，随机分为对照组和观察组，每组36例。对照组自术前1 d的22:00开始常规禁食禁饮，观察组在此基础上于麻醉前2 h口服300 mL碳水化合物。对2组患者的麻醉前胃窦超声检查结果、Perlas分级、饱胃情况、口渴和饥饿VAS评分、苏醒时间、气管拔管时间、术中低体温情况、胃肠功能恢复时间及不良反应情况进行比较。

结果

麻醉前2组患者的右侧卧位胃窦部横截面积（CSA）、胃容积（GV）、胃容积与体质量比（GV/W）比较，差异均无统计学意义（

0.05）。2组患者的胃窦超声Perlas分级和饱胃发生率比较，差异均无统计学意义（

0.05）。在麻醉前即刻，观察组患者的口渴和饥饿视觉模拟量表（VAS）评分均显著低于对照组(

0.05)。观察组患者的苏醒时间、气管拔管时间和术中低体温发生率均明显短/低于对照组(

0.05)。观察组患者术后首次排气时间、首次排便时间及腹胀发生率均明显短/低于对照组(

0.05)。

结论

对于以Trendelenburg体位行腹腔镜子宫切除的超重或肥胖患者，麻醉前2 h口服300 mL碳水化合物不增加反流误吸风险，安全可靠，不仅可以提高患者舒适度，促进麻醉后苏醒，还能够降低术中低体温和消化道不良反应发生率，有利于加快术后康复。

Abstract

Objective

To clarify the effect of preoperative oral carbohydrate on overweight or obese patients undergoing laparoscopic hysterectomy in Trendelenburg position.

Methods

A total of 72 overweight or obese patients who underwent laparoscopic hysterectomy in Trendelenburg position at Yancheng Third People's Hospital from September 2022 to August 2024 were selected，and randomly divided into the control group and the observation group，with 36 cases in each group. The control group received routine restriction of fasting and fluid starting from 22：00 on the day before surgery，while the observation group was given an additional 300 mL of carbohydrate orally 2 hours before anesthesia on the basis of the control group. The preoperative ultrasound results of gastric antrum，Perlas classification，full stomach status，visual analogue scale （VAS） scores for thirst and hunger，awakening time，tracheal extubation time，intraoperative hypothermia，gastrointestinal function recovery time，and adverse reactions were compared between the two groups.

Results

Before anesthesia，there was no statistically significant difference in the cross-sectional area of the gastric antrum （CSA） in the right lateral position，gastric volume （GV），or the ratio of gastric volume to body weight （GV/W） between the two groups（

0.05）. There was also no statistically significant difference in the Perlas classification of gastric antrum ultrasound or the incidence of full stomach between the two groups （

0.05）. Immediately before anesthesia，the VAS scores for thirst and hunger in the observation group were significantly lower than those in the control group （

0.05）. The awakening time，tracheal extubation time，and incidence of intraoperative hypothermia in the observation group were significantly shorter/lower t

han those in the control group （

0.05）. The observation group had significantly shorter time of first exhaust and defecation after surgery，as well as lower incidence of postoperative bloating，compared with the control group （

0.05）.

Conclusion

For overweight or obese patients undergoing laparoscopic hysterectomy in the Trendelenburg position，oral intake of 300 mL carbohydrate 2 hours before anesthesia does not increase the risk of regurgitation or aspiration，with safety and reliability. It not only can improve comfort of patients and promote post-anesthesia awakening，but also can reduce the incidences of intraoperative hypothermia and gastrointestinal adverse reactions，which is conducive to accelerating postoperative recovery.

关键词

Keywords

references

中华医学会外科学分会，中华医学会麻醉学分会 . 中国加速康复外科临床实践指南（2021）（二）［J］. 中华麻醉学杂志， 2021 ， 41 （ 9 ）： 1035 - 1043 . doi： 10.12290/xhyxzz.20210002 http://dx.doi.org/10.12290/xhyxzz.20210002 .

吴可汀，高巨，辛超，等 . 术前口服碳水化合物对腹腔镜胆囊切除术患者胃排空的影响［J］. 中华麻醉学杂志， 2022 ， 42 （ 9 ）： 1039 - 1042 . doi： 10.3760/cma.j.cn131073.20220614.00904 http://dx.doi.org/10.3760/cma.j.cn131073.20220614.00904 .

李雨虹，任志强，尹宁 . 肥胖女性术前口服碳水化合物后胃排空评估的非劣效性研究［J］. 重庆医学， 2024 ， 53 （ 4 ）： 587 - 591 . doi： 10.3969/j.issn.1671-8348.2024.04.021 http://dx.doi.org/10.3969/j.issn.1671-8348.2024.04.021 .

李雨虹，尹宁，马晴，等 . 术前口服不同容量碳水化合物对腹腔镜妇科手术患者胃液量的影响［J］. 临床麻醉学杂志， 2023 ， 39 （ 2 ）： 154 - 158 . doi： 10.12089/jca.2023.02.009 http://dx.doi.org/10.12089/jca.2023.02.009 .

严志勇，樊倩楠，苏小虎，等 . 不同CO 2 气腹压力对老年肥胖患者全身麻醉行腹腔镜下子宫切除的影响［J］. 局解手术学杂志， 2022 ， 31 （ 5 ）： 439 - 442 . doi： 10.11659/jjssx.12E021100 http://dx.doi.org/10.11659/jjssx.12E021100 .

周理，齐晓轩，韩艳芳，等 . 术前饮用碳水化合物饮料对老年胸科手术病人麻醉诱导前胃容量及围术期低血压的影响［J］. 实用老年医学， 2023 ， 37 （ 7 ）： 671 - 675 . doi： 10.3969/j.issn.1003-9198.2023.07.007 http://dx.doi.org/10.3969/j.issn.1003-9198.2023.07.007 .

黎佳，孙凯，严敏 . 床旁胃超声在特殊人群临床应用研究进展［J］. 国际麻醉学与复苏杂志， 2021 ， 42 （ 1 ）： 80 - 82 . doi： 10.3760/cma.j.cn321761-20200224-00199 http://dx.doi.org/10.3760/cma.j.cn321761-20200224-00199 .

徐幻浠，李先蕊，吴浩，等 . 不同人格腹腔镜下子宫切除老年病人术后谵妄发生情况及危险因素分析［J］. 实用老年医学， 2023 ， 37 （ 10 ）： 1019 - 1022 . doi： 10.3969/j.issn.1003-9198.2023.10.010 http://dx.doi.org/10.3969/j.issn.1003-9198.2023.10.010 .

de Klerk ES ， de Grunt MN ， Hollmann MW ， et al . Incidence of excessive preoperative fasting： a prospective observational study ［J］. Br J Anaesth ， 2023 ， 130 （ 4 ）： e440 - e442 . doi： 10.1016/j.bja.2022. 12.017 http://dx.doi.org/10.1016/j.bja.2022.12.017 .

丁献菊，马平康，王雅菊，等 . ERAS理念下术前口服碳水化合物对全身麻醉妇科腹腔镜手术患者的影响［J］. 河南大学学报（医学版）， 2023 ， 42 （ 3 ）： 225 - 229 .

Sessler DI . Perioperative temperature monitoring ［J］. Anesthesiology ， 2021 ， 134 （ 1 ）： 111 - 118 . doi： 10.1097/ALN.0000000000003481 http://dx.doi.org/10.1097/ALN.0000000000003481 .

李利利，汪欢，贾贝尔，等 . 术前禁食禁饮与围手术期意外低体温及其相关性的研究进展［J］. 国际麻醉学与复苏杂志， 2024 ， 45 （ 7 ）： 741 - 744 . doi： 10.3760/cma.j.cn321761-20240220-01078 http://dx.doi.org/10.3760/cma.j.cn321761-20240220-01078 .

Teigen NC ， Sahasrabudhe N ， Doulaveris G ， et al . Enhanced recovery after surgery at cesarean delivery to reduce postoperative length of stay： a randomized controlled trial ［J］. Am J Obstet Gynecol ， 2020 ， 222 （ 4 ）： 372.e1 - 372.e10 . doi： 10.1016/j.ajog.2019.10.009 http://dx.doi.org/10.1016/j.ajog.2019.10.009 .

Marquini GV ， Pinheiro F ， Vieira A ， et al . Effects of preoperative fasting abbreviation with carbohydrate and protein solution on postoperative symptoms of gynecological surgeries：double-blind randomized controlled clinical trial ［J］. Rev Col Bras Cir ， 2020 ， 46 （ 5 ）： e20192295 . doi： 10.1590/0100-6991e-20192295 http://dx.doi.org/10.1590/0100-6991e-20192295 .

魏越，陆希，张静，等 . 术前2 h口服碳水化合物对妇科腹腔镜特殊体位手术患者胃容量及反流误吸风险的影响［J］. 北京大学学报（医学版）， 2023 ， 55 （ 5 ）： 893 - 898 . doi： 10.19723/j.issn.1671-167X.2023.05.018 http://dx.doi.org/10.19723/j.issn.1671-167X.2023.05.018 .

魏兰璎，孟丽华，薛荣亮 . 术前口服多维碳水化合物对老年患者全髋关节置换术围术期应激反应的影响［J］. 临床麻醉学杂志， 2022 ， 38 （ 10 ）： 1036 - 1040 . doi： 10.12089/jca.2022.10.005 http://dx.doi.org/10.12089/jca.2022.10.005 .

席欣欣，郭红，黎姗，等 . 术前口服碳水化合物对剖宫产术后加速康复的影响［J］. 国际妇产科学杂志， 2024 ， 51 （ 6 ）： 616 - 619 . doi： 10.12280/gjfckx.20240649 http://dx.doi.org/10.12280/gjfckx.20240649 .

Views

下载量

CSCD

Alert me when the article has been cited

提交

Tools

Publicity Resources

Effects of different CO₂ pneumoperitoneum pressures on overweight or obese patients with laparoscopic panhysterectomy in Trendelenburg position

Research progress on the role of amino acids in glycolipid metabolism disorders

Research advances in the role of exercise prescription regulating adipokine mediated obesity-related metabolic diseases

Effect of different exercise modes on people with nonalcoholic fatty liver disease and obesity

Effects of different sevoflurane elution methods on awakening quality and cognitive function of elderly obese patients undergoing hip joint replacement

Related Author

WANG Hao

GU Ke

RAO Li-hua

HU Bei

JI Wei-wei

DAI Ti-jun

TIAN Zhen

XU Ying-jiang

Related Institution

Department of Anesthesiology，Nanjing Drum Tower Hospital Group Suqian Hospital

Department of Interventional Vascular Surgery，Binzhou Medical University Hospital

First Clinical Medical School，Binzhou Medical University

Taiyuan Medical Association

Department of Cardiovascular Medicine，Taiyuan Central Hospital

⁰