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Postoperative Oral CarbohydratesEarly Phase 1NCT05867264

Effect of Early Postoperative Oral Carbohydrate on Postoperative Recovery of the Unilateral Knee Arthroplasty

A Early Phase 1 study testing Early drinking water, Early consumption of carbohydrates and Late feeding group in people with Postoperative Oral Carbohydrates and Postoperative Recovery, run by Hongwei Shi.

Unknown status

Status not confirmed. The sponsor has not verified this record for over two years, so it may be out of date.

Official record
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Trial summary

To evaluate the effect of early postoperative oral carbohydrate on postoperative recovery of the unilateral knee arthroplasty Read more about this study

Who is it for?
Ages 18 to 79 yearsHealthy volunteers can take part
What is being tested?
Early drinking water, Early consumption of carbohydrates and Late feeding group
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
672 participants
Where
No sites listed yet
Study dates
25 May 2023to 30 Dec 2024
Phase
Early Phase 1
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 to 79 years
  • All sexes
  • Healthy volunteers accepted
  • Adult, Older adult

Who may be able to join

  • Age 18-79 years.
  • Patients undergoing unilateral total knee arthroplasty or unicondylar joint replacement.
  • Normal diet.
  • ASA grade I~Ⅲ;
  • BMI 18-30kg /m2.
  • No intraspinal anesthesia contraindications.

Who cannot join

  • Preoperative existence of gastric emptying disorders, such as gastrointestinal obstruction, gastroesophageal reflux, or previous gastrointestinal surgery.
  • Patients with diabetes mellitus, severe renal dysfunction, or other severe metabolic diseases.
  • History of motion sickness.
  • Mental disorder, alcoholism, or a history of substance abuse.
  • Patients with abnormal swallowing function.
  • The operation time is greater than 3 hours.
  • Maltodextrin fructose allergy or intolerance.

Trial locations and contacts

No sites are listed yet.

About this study

Official title: Effect of Early Postoperative Oral Carbohydrate on Postoperative Recovery of the Unilateral Knee Arthroplasty: a Randomized, Single-blind, Parallel-controlled, Multicenter Study

To evaluate the effect of early postoperative oral carbohydrate on postoperative recovery of the unilateral knee arthroplasty

Read the detailed description

Currently, most clinical studies on the impact of oral carbohydrates on postoperative recovery are focused on the preoperative stage, with only a few small sample studies indicating that postoperative oral carbohydrates can improve patient comfort. Orthopedic surgery, especially joint surgery, requires patients to start functional exercise as soon as possible after surgery. Joint replacement surgery requires reducing the consumption of muscle tissue caused by protein breakdown. Perioperative nutritional support for patients is of great significance for postoperative muscle function recovery and good functional exercise. However, further systematic research on the impact of early postoperative oral carbohydrates on postoperative recovery is still lacking.

This study selected patients who underwent unilateral total knee arthroplasty or single condylar arthroplasty. All surgical patients undergo homogenized preoperative preparation and intraoperative anesthesia management. Eligible patients were screened before surgery, and an informed consent form was signed. Patients enrolled in the experiment were randomly assigned into one of the three groups. They are the early feeding group (EOF1, EOF2group) and the late feeding group (control group). Evaluate the effectiveness and safety of early postoperative feeding (EOF) in orthopedic surgery patients by measuring indicators such as insulin resistance index, QoR-15, and prealbumin and retinol binding protein.

Being tested
Early drinking water, Early consumption of carbohydrates, Late feeding group

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Early drinking waterOther

    After passing the evaluation by the anesthesiologist team in PACU, the EOF1 group drank 200ml of water.

    The evaluation criteria for the anesthesiologist team are:

    1. Steward's awakening score is ≥ 6 points.
    2. Level of sobriety ≥ 3.
    3. There is no need to wait for intestinal peristalsis, based on the patient's wishes, and the feeding should be completed within 2 hours after the surgery.
  • Early consumption of carbohydratesCombination product

    After passing the evaluation by the anesthesiologist team in PACU, the EOF2 group had a drinking capacity of 200ml of 12.5% carbohydrates (100ml containing 12.5g of maltodextrin, fructose, and glucose).

    The evaluation criteria for the anesthesiologist team are:

    1. Steward's awakening score is 6 points.
    2. Level of sobriety ≥ 3.
    3. There is no need to wait for intestinal peristalsis, based on the patient's wishes, and the feeding should be completed within 2 hours after the surgery.
  • Late feeding groupOther

    After observing the vital signs for 30 minutes after surgery, patients in Group C were sent back to the ward to continue fasting and drinking for at least 6 hours. After the anus exhausts, they began to gradually drink and eat

Study groups in NCT05867264
Study groupRoleWhat they receive
EOF 1 group:Early drinking water groupPlacebo comparatorAfter passing the evaluation by the anesthesiologist team in PACU, the EOF1 group drank 200ml of water.
Receives: Other: Early drinking water
EOF 2 group: Early oral carbohydrate groupExperimentalAfter passing the evaluation by the anesthesiologist team in PACU, the EOF2 group had a drinking capacity of 200ml of 12.5% carbohydrates (100ml containing 12.5g of maltodextrin, fructose, and glucose).
Receives: Combination Product: Early consumption of carbohydrates
Control group: Late feeding groupPlacebo comparatorAfter observing the vital signs for 30 minutes after surgery, patients in Group C were sent back to the ward to continue fasting and drinking for at least 6 hours. After the anus exhausts, they began to gradually drink and eat
Receives: Other: Late feeding group

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Insulin resistance index at fasting

    In the venous blood in an early morning fasting state, the change in the insulin resistance index can reflect whether the carbohydrate administration is favorable in the early postoperative period.

    Measured: 1 day after surgery

Secondary outcomes (14)
  1. Insulin resistance index at fasting

    In the venous blood in an early morning fasting state, the change in the insulin resistance index can reflect whether the carbohydrate administration is favorable in the early postoperative period.

    Measured: on the day of the surgery

  2. Insulin resistance index at fasting

    In the venous blood in an early morning fasting state, the change in the insulin resistance index can reflect whether the carbohydrate administration is favorable in the early postoperative period.

    Measured: 3 days after surgery

  3. Pre albumin levels and retinol binding protein levels

    The change in prealbumin levels and retinol-binding protein levels in venous blood in a fasting state in the early morning can reflect whether carbohydrate administration is favorable in the early postoperative period. Three of the eight test centers examined the pre-albumin levels and retinol-binding protein levels.

    Measured: on the day of surgery, 1 day and 3 days after surgery.

  4. The 15-item recovery quality rating scale (QoR-15)

    QoR-15 was used to assess five aspects of postoperative recovery quality (physical comfort, physical independence, psychological support, emotion and pain), with higher scores indicating the higher postoperative recovery quality. The lowest score is 0 points, and the highest score is 150 points.

    Measured: Up to 48 hours postoperative

  5. The NRS score for the thirst thirst and hunger.

    The Numerical Rating Scale (NRS) is used to assess the degree of thirst and hunger in patients, with a score of 0 to 10. A score of 0 represents no thirst and no hunger, while a score of 10 represents unbearable thirst and hunger. The thirst and hunger score indicates that early postoperative carbohydrate administration is beneficial.

    Measured: 2 hours, 6 hours and 8 hours after surgery

  6. The degree of abdominal distension

    Using grading method, complaining of abdominal distention, tolerable, feeling gas rolling in the abdomen, no obvious abdominal signs, mild abdominal distension, abdominal distention, moderate abdominal distension, vomiting, dyspnea, and significant abdominal bulge.

    Measured: 24 hours after surgery

  7. Incidence of reflux aspiration and hypoxemia

    Reflux aspiration is defined as severe cough followed by hypoxemia and lung rale after vomiting. Hypoxemia is defined as SpO2<91% under air inhalation.

    Measured: 24 hours after surgery

  8. Anal exhaust time

    The advanced time of the first postoperative anal exhaust indicates a favorable early postoperative carbohydrate administration.

    Measured: Up to 48 hours postoperative

  9. Incidence of postoperative nausea and vomiting

    The lower the incidence and severity of postoperative nausea and vomiting, indicating that early administration of carbohydrates after surgery is beneficial.

    Measured: Up to 48 hours postoperative

  10. Hospitalization time

    The shortened length of hospital stay indicated that early postoperative carbohydrate administration was advantageous.

    Measured: Up to 7days postoperative

  11. The extent of the postoperative pain

    The total amount of sufentanil consumed by the patient 48 hours after operation, the number of effective presses of the analgesia pump, the number of times of rescue analgesia and the amount of rescue drugs were converted into the total amount of morphine.

    Measured: Up to 48 hours postoperative

  12. Patient satisfaction score

    Rated on a 0-10 scale, with a higher score representing greater satisfaction.

    Measured: Up to 48 hours postoperative

  13. The incidence and severity of various adverse events (AE) from the start of oral carbohydrates until the end of the trial

    The lower the incidence and severity of various adverse events (AE) from the start of postoperative oral carbohydrates until the end of the trial, it indicates that the early postoperative carbohydrate administration is beneficial.

    Measured: Up to 48 hours postoperative

  14. Number of antiemetic uses

    The less use of antiemetic drugs within 24h after the first start of postoperative administration indicates that early postoperative carbohydrate administration is advantageous.

    Measured: Up to 24 hours after the first start of drug administration.

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted19 May 2023
  2. Study start25 May 2023 (estimated)
  3. Primary completion30 Dec 2024 (estimated)
  4. Study completion30 Dec 2024 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Early Phase 1
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
Single blind
Who is masked
Investigator
Enrolment
672 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT05867264
Sponsor's protocol ID
Nanjing First Hospital
Status last verified
May 2023
First submitted
8 Apr 2023
Last updated
19 May 2023
Results posted
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Publications

  • Miller TE, Roche AM, Mythen M. Fluid management and goal-directed therapy as an adjunct to Enhanced Recovery After Surgery (ERAS). Can J Anaesth. 2015 Feb;62(2):158-68. doi: 10.1007/s12630-014-0266-y. Epub 2014 Nov 13.

    PubMed 25391735
  • Rizvanovic N, Nesek Adam V, Causevic S, Dervisevic S, Delibegovic S. A randomised controlled study of preoperative oral carbohydrate loading versus fasting in patients undergoing colorectal surgery. Int J Colorectal Dis. 2019 Sep;34(9):1551-1561. doi: 10.1007/s00384-019-03349-4. Epub 2019 Jul 15.

    PubMed 31309323
  • Nygren J, Thorell A, Ljungqvist O. Preoperative oral carbohydrate therapy. Curr Opin Anaesthesiol. 2015 Jun;28(3):364-9. doi: 10.1097/ACO.0000000000000192.

    PubMed 25827282
  • Surgery Branch of Chinese Medical Association, Anesthesiology Branch of Chinese Medical Society. Chinese Expert Consensus and Path Management Guidelines for Accelerating Rehabilitation Surgery (2018) [J]. Chinese Journal of Anesthesiology, 2018,38 (001): 8-13.

  • Yang R, Tao W, Chen YY, Zhang BH, Tang JM, Zhong S, Chen XX. Enhanced recovery after surgery programs versus traditional perioperative care in laparoscopic hepatectomy: A meta-analysis. Int J Surg. 2016 Dec;36(Pt A):274-282. doi: 10.1016/j.ijsu.2016.11.017. Epub 2016 Nov 10.

    PubMed 27840308
  • Bethune Orthopaedic Accelerated Rehabilitation Alliance, Bethune Charity Foundation Orthopaedic Professional Committee of trauma, Joint Surgery Professional Committee of Bethune Charity Foundation, etc. Guidelines for the management of perioperative fasting fasting in orthopaedic surgery [J]. Chinese Journal of Trauma and Orthopedics, 2019,21 (10): 829-834.

  • Smith MD, McCall J, Plank L, Herbison GP, Soop M, Nygren J. Preoperative carbohydrate treatment for enhancing recovery after elective surgery. Cochrane Database Syst Rev. 2014 Aug 14;2014(8):CD009161. doi: 10.1002/14651858.CD009161.pub2.

    PubMed 25121931
  • Noba L, Wakefield A. Are carbohydrate drinks more effective than preoperative fasting: A systematic review of randomised controlled trials. J Clin Nurs. 2019 Sep;28(17-18):3096-3116. doi: 10.1111/jocn.14919. Epub 2019 Jun 10.

    PubMed 31112338
  • [9] Wang Cuilan, Huang Yuting, Zeng Qing, et al. Study on postoperative fasting water prohibition time under ERAS concept [J]. Clinical Medical Engineering, 2022,29 (4): 2.

Questions about this trial

What is this clinical trial studying?

A Early Phase 1 study testing Early drinking water, Early consumption of carbohydrates and Late feeding group in people with Postoperative Oral Carbohydrates and Postoperative Recovery, run by Hongwei Shi.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 6 inclusion and 7 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: status not confirmed, as of the sponsor's last update on 19 May 2023. Status can change between updates, so confirm with the study contact before making plans.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. Some participants in this study may receive a placebo. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Early Phase 1 (sometimes called Phase 0) studies give a very small amount of a treatment to a few people, mainly to see how the body handles it.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

Results are not available in the source record.

How can a doctor refer a patient or contact the research team?

Contact Liu Han (18951670163, han_cold.student@sina.com), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Insulin resistance index at fasting (time frame: 1 day after surgery). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT05867264, which also lists 9 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 19 May 2023.

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