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April 26, 2026Maltepe Tıp Dergisi0 citationsOpen Access

Effect Of Preoperative Oral Carbohydrate Solutions on Controlled Hypotension: A Randomized Controlled Trial

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MSMuhammet Selman SöğütSŞSelçuk Şimşek

Key Result

Preoperative 10% Dextrose did not significantly reduce intraoperative Remifentanil requirement compared to control (0.21 vs 0.18 mcg/kg/min; p=0.083) in surgeries requiring controlled hypotension.

Key Points

  • This trial aims to evaluate the impact of preoperative carbohydrate-rich fluids on intraoperative narcotic analgesic requirements during surgeries requiring controlled hypotension.
  • Randomized controlled trial conducted at Maltepe University Hospital with 40 surgical patients.
  • Participants were split into two groups: one receiving 400 ml of 10% dextrose solution 2 hours before surgery and a control group without carbohydrate intake.
  • Primary outcome measured was the amount of remifentanil per kilogram per time unit consumed during the surgery.
  • No significant difference in remifentanil dosage between the experimental group (0.21 mcg/kg/min) and the control group (0.18 mcg/kg/min) was observed (p=0.083).
  • No meaningful differences were found in average heart rates and systolic blood pressures during surgery.
  • Preoperative carbohydrate intake did not significantly reduce narcotic analgesic needs, indicating limited effects on anesthetic management.

Study Design

Type

RCT (n=40)

Multicenter

No

Structured PICO

Does preoperative oral 10% Dextrose solution reduce intraoperative Remifentanil requirement in patients undergoing surgery requiring controlled hypotension?

P
Population
40 patients scheduled for surgery requiring controlled hypotension at an ENT clinic
I
Intervention
400 ml 10% Dextrose solution orally two hours before surgery
C
Comparator
No preoperative carbohydrates
O
Outcome
Amount of Remifentanil consumed per unit time per patient's weight (mcg/kg/min)surrogate

Preoperative oral carbohydrate loading does not significantly reduce intraoperative narcotic analgesic requirements during surgeries requiring controlled hypotension.

Main Result

Absolute Event Rate: 0.21% vs 0.18%

p-value: p=0.083

Abstract

Amaç: Bu çalışma, kontrollü hipotansiyon gerektiren cerrahilerde, preoperatif olarak karbonhidratça zengin sıvı tüketiminin, intraoperatif narkotik analjezik gereksinimi üzerindeki etkisini değerlendirmeyi amaçlamıştır. Materyal-Metodlar: Maltepe Üniversitesi Tıp Fakültesi Hastanesi Kulak Burun Boğaz Kliniğinde, cerrahi müdahale planlanan 40 hastanın dahil edildiği randomize kontrollü bir çalışma yapılmıştır. Katılımcılar iki gruba ayrılmıştır: biri cerrahiden iki saat önce 400 ml %10 Dekstroz solüsyonu alan grup, diğeri preoperatif karbonhidrat almayan kontrol grubudur. Birincil sonuç ölçümü, hastanın kilosu başına zaman birimi başına tüketilen Remifentanil miktarı olarak belirlenmiştir. İkincil sonuç ölçümleri olarak, ameliyat sırasında kaydedilen ortalama kalp hızı ve ortalama sistolik kan basıncı ile ek antihipertansif ilaç kullanımı değerlendirilmiştir. Bulgular: Deney grubunda ortalama 0,21 (0,05) mcg/kg/dk, kontrol grubunda ise 0,18 (0,02) mcg/kg/dk (p=0,083) olarak saptanan Remifentanil dozu açısından gruplar arasında anlamlı bir fark bulunmamıştır. Benzer şekilde, ameliyat süresi, sistolik arter basınçları ve ameliyat sırasındaki kalp hızları arasında da anlamlı bir fark görülmemiştir. Sonuç: Preoperatif olarak karbonhidratça zengin sıvı tüketimi, kontrollü hipotansiyon gerektiren cerrahilerde narkotik analjezik ihtiyacını anlamlı ölçüde azaltmamıştır. Bu bulgular, preoperatif karbonhidrat yüklemesinin güvenli olduğunu ve mevcut beslenme kılavuzlarıyla uyumlu olduğunu göstermekle birlikte, narkotik analjezik gereksinimi ve intraoperatif anestezi yönetimi üzerindeki etkisinin sınırlı olabileceğini düşündürmektedir. Farklı cerrahi alanlarda preoperatif beslenme girişimlerinin olası yararlarını araştırmak üzere daha fazla çalışmaya ihtiyaç vardır.

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Cite This Study

Söğüt et al. (2026) conducted an RCT in Surgeries requiring controlled hypotension (n=40). 10% Dextrose solution vs. No preoperative carbohydrates was evaluated on Amount of Remifentanil consumed per unit time per patient weight (mcg/kg/min) (p=0.083). Preoperative 10% Dextrose did not significantly reduce intraoperative Remifentanil requirement compared to control (0.21 vs 0.18 mcg/kg/min; p=0.083) in surgeries requiring controlled hypotension.

synapsesocial.com/papers/69edacdb4a46254e215b4969https://doi.org/10.35514/mtd.2026.139
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1The Effect of Preoperative Oral Carbohydrate Loading on Stress Response in Patients Undergoing Major or Minor Surgery2011 · 14 citations
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  4. 4The effect of preoperative oral carbohydrate administration on postoperative glucometabolic response, subjective well being and quality of life in patients undergoing colorectal surgery: a randomized controlled double-blind study2025 · 7 citations
  5. 5Evaluation of the effects of esmolol and remifentanil for controlled hypotension application on hemodynamics and oxidative stress parameters2020