Comparative study of physiological changes of nil per oral vs glucose water vs free water in patients undergoing laparoscopic cholecystectomy: A randomized prospective study


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Article type :

Original Article

Author :

Neelesh Anand, Shashi Prakash, Mandeep M H Madia, Braj Nandan Singh, Reetika Gupta

Volume :

8

Issue :

2

Abstract :

Background: The aim of this study was to compare the effect of ingestion of clear water and glucose water over 10 hours NPO in elective laparoscopic cholecystetctomy surgery. Materials and Methods: An observational study was conducted in Sir Sunderlal hospital, Banaras Hindu University. The study included ASA I-II patients undergoing laparoscopic cholecystectomy surgery. Patients undergoing general anaesthesia were included in the study. Among three groups, the control fasted in accordance to nil per os for 10 hours, second and third group received 200 mL of clear water and 200 ml of glucose water, respectively 2 hours before the surgery. Arterial Blood Gas analysis and blood glucose level was done in the immediate post-operative period. Arterial pH, serum electrolytes, serum lactate and blood glucose levels were compared for the above 3 groups. Results were given as mean ± SD. Data collected were analysed using Student’s t-test. Differences were considered statistically significant if P values were Results: A total of 45 patients were included and 15 patients each were randomly assigned to one of the 3 groups. Patients who had 200 ml of clear water before surgery had lesser variation in serum K [p=0.045]. and serum lactate level [p=0.001] than NPO. Patients fed with 200 ml of glucose water before surgery had lesser variation in serum K level [p=0.02], serum lactate level [p Conclusion: We conclude that it is safe to give clear drinks 2 hours prior to surgery. Prolonged withholding of oral fluid may cause imbalance in pH, serum electrolytes and hypoglycaemia. The finding confirms the recent ASA guidelines which no longer recommends an indiscriminate ‘NPO after midnight’ policy.

Keyword :

 Glucose water, Hypoglycaemia, Laparoscopic cholecystectomy.
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