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| Effect of preoperative oral rehydration salt on postoperative rehabilitation process and prognosis in patients undergoing radical mastectomy |
| ZI Congna1 FAN Juan1 LI Yanming2 LI Fulong1 MA Xian3 XING Zhen1 |
1.Department of Anesthesiology, the First Affiliated Hospital of Hebei North University, Hebei Province, Zhangjiakou 075000, China;
2.Operating Room, the First Affiliated Hospital of Hebei North University, Hebei Province, Zhangjiakou 075000, China;
3.Department of Laboratory Medicine, the First Affiliated Hospital of Hebei North University, Hebei Province, Zhangjiakou 075000, China |
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Abstract Objective To study the effect of preoperative oral rehydration salt (ORS) on postoperative rehabilitation process and prognosis in patients undergoing radical mastectomy. Methods From October 2017 to March 2018, 80 cases undergoing elective radical mastectomy in the First Affiliated Hospital of Hebei North University were selected. According to the random number table method, they were divided into observation group and control group, with 40 cases in each group. Both groups were given the same anesthesia and surgical plan. Control group was treated with fasting at 8 h on preoperative and water-deprivation at 4 h on preoperative, fluid infusion during surgery. Observation group was given oral ORS solution 300 mL at 2 h on preoperative. The fluid infusion volume was adjusted according to the patient′s condition. The changes in heart rate (HR), mean arterial pressure (MAP) and oxygen saturation (SpO2) were monitored at entering room and rest state (T0), at immediate intubation time (T1), at 10 min after start of surgery (T2), at end of surgery immediately (T3) and 1 d after surgery (T4). The levels of fasting plasma glucose (FPG), fasting insulin (FINS), C-reactive protein (CRP) and tumor necrosis factor-α (TNF-α) at 1 d before surgery (preoperative) and 1 d after surgery (postoperative) were observed. The anesthesia time, intraoperative transfusion volume, anesthesia recovery time, the first anal exhaust time, the first eating time, leaving bed time and incidence of adverse reactions were statistically analyzed. The survival at 1 year on postoperative was recorded. Results Comparison between groups, comparison between time points and the interaction comparison showed statistically significant differences (all P < 0.05). HR, MAP at time points T1, T2 were higher than T0 in same group of two groups, and the differences were statistically significant (all P < 0.05). HR, MAP at time points T1, T2, T3 in observation group were all lower than those in control group, and the differences were statistically significant (all P < 0.05). There were no statistically significant differences in FPG, FINS, CRP and TNF-α between two groups on preoperative (all P > 0.05). FPG, FINS, CRP and TNF-α on postoperative were significantly higher than those on preoperative, and observation group was lower than control group, and the differences were statistically significant (P < 0.05). There were no significant differences between two groups in anaesthesia time, anaesthesia recovery time and leaving bed time on postoperative (all P > 0.05). Intraoperative infusion volume was less than that of control group, the first anal exhaust time and the first eating time in observation group were shorter than those in control group, and the differences were statistically significant (all P < 0.05). The incidence of total adverse reactions in observation group was lower than that in control group, and the difference was statistically significant (P < 0.05). At 1 year on postoperative, survival rates of two groups were both 100%. Conclusion Oral ORS for patients before radical mastectomy can maintain stability of intraoperative blood pressure and HR to a certain extent, improve postoperative recovery and occurrence of adverse reactions, with few effects on survival within 1 year.
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