Effect of Preoperative Oral Carbohydrate on Hypotension After Anesthesia Induction in Elderly Patients With Joint Replacement

Study Overview
=================
Brief Summary
-----------------
The goal of this Randomized controlled trial is to investigate the effect of shortening the duration of preoperative oral carbohydrate drinks on blood pressure after anesthesia induction in elderly patients undergoing joint replacement surgery. The main question it aims to answer is Whether preoperative oral carbohydrate drinks can reduce the incidence of hypotension after anesthesia-induced hypotension in elderly patients undergoing joint replacement surgery.According to the numerical table method, the patients in the experimental group will drink carbohydrate drinks the night before the operation and 3 hours before the operation, and the control group patients will routinely fast

Official Title
-----------------
Effect of Preoperative Oral Carbohydrate Shortening the Fasting Period on Hypotension After Anesthesia Induction in Elderly Patients With Joint Replacement

Conditions
-----------------
Carbohydrates, Aged, Post-induction Hypotension

Intervention / Treatment
-----------------
* Dietary Supplement: Carbohydrate


Participation Criteria
=================
Eligibility Criteria
-----------------
Inclusion Criteria: Patients undergoing elective unilateral joint replacement (total hip or knee) ASAⅠ-Ⅲ Exclusion Criteria: Diagnosed patients at high risk of reflux aspiration (diabetes mellitus, obesity (BMI>30), gastrointestinal obstruction, elevated intracranial pressure, and esophageal disease) Eating disorders History of gastrointestinal or epigastric surgery Recent use of drugs that affect gastrointestinal motility Heart disease (severe arrhythmias, severe heart valve disease, heart failure, unstable angina on the day of surgery) Severe poorly controlled hypertension (MAP≥135 mmHg) or hypotension (MAP≤55 mmHg) before induction Difficult airway Severe hepatic and renal insufficiency

Ages Eligible for Study
-----------------
Minimum Age: 65 Years
Maximum Age: 80 Years

Sexes Eligible for Study
-----------------
All

Accepts Healthy Volunteers
-----------------
No

Study Plan
=================
How is the study designed?
-----------------

Design Details

Primary Purpose: Prevention
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Quadruple


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Carbohydrate group<br>Fasting at 20:00 on the eve of surgery, give 800ml of carbohydrate drink, the patient drinks freely, no more than 200ml per hour, to 3h before surgery, give carbohydrate drink again, according to 5ml/kg calculated dose, maximum 400ml, drink within 30 minutes. | Dietary Supplement: Carbohydrate<br>* To ensure the safety of the trial, preoperative gastric ultrasound measurements will be performed on all patients to assess their gastric volume. See above for other details<br>|
| No Intervention: Contral group<br>Fasting at 20:00 on the eve of surgery, fasting at 24:00, until the induction of anesthesia on the day of surgery | |

What is the study measuring?
-----------------
Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Incidence of hypotension | No surgical manipulation is performed within 20 minutes | 20 minutes after induction of anesthesia | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Duration of fasting and drinking |  | 1 day before the operation | 
| Antral cross-sectional area |  | 30 minutes before anesthesia induction | 
| Incidence of hypotension |  | during the whole operation | 
| The dosage of vasoactive drugs |  | 20 minutes after induction of anesthesia | 
| Thirst and hunger VAS score |  | 3 hours before and 1 day after the operation | 
| Fasting blood glucose and insulin resistance index |  | 3 hours before the operation | 
| Incidence of nausea and vomiting |  | 1 day after the operation |