Gatorade now provided to some pre-surgical patients to counter thirst complaint
If you’ve ever had your gallbladder removed or a knee ACL repaired you know the drill – no food or liquids (other than a sip of water) past midnight the day before the surgery. The steadfast rule, long imposed by doctors who administer anesthesia, was thought to be essential in preventing the risk of aspiration - food and liquid coming back up from the stomach and infiltrating the airway, while the patient is anesthetized.
“Things are changing now with a movement toward patient-centered care,” said Ruben Azocar, MD, Anesthesiologist-in-Chief at Tufts Medical Center. “Patient outcomes are critically important, but we also need to make sure patients have the best experience possible during this stressful time of surgery. Fortunately, there was new evidence that allowed us to make some changes.”
The issue arose in the summer of 2016 when Dr. Azocar reviewed patient satisfaction scores. To his surprise, patients complained most about their intense thirst, especially when needing to wait 12-15 hours from the time of their last sip to the start of a procedure. A number of new studies seemed to suggest that not only might a carbohydrate drink lessen thirst, it might actually help patients recover faster.
“The data suggests giving a carb drink the morning of surgery might help wound healing and in gastrointestinal surgeries, return the bowel function faster. Glucose levels in those with diabetes may also be better controlled,” said Dr. Azocar.
As part of a pilot, patients coming into Tufts Medical Center for either colorectal surgeries or orthopedic procedures were given a bottle of Gatorade to drink two hours before the surgery. After three months, the number of patients who reported feeling thirsty decreased by ten percent from October to December 2016.
“If we continue to have good results in both satisfaction scores and outcomes, we’ll institute the Gatorade rule across all surgeries,” said Dr. Azocar.
Shaking Up the Pre-Surgery Routine
Anesthesiologists at Tufts MC are also giving pre-surgical patients special protein drinks that have been demonstrated to boost the immune system. Each patient receives 15 cartons of the special amino-acid mixture and instructed to take them three times a day for five days prior to the procedure.
“The idea is to optimize the patient’s health before they undergo anesthesia,” explained Dr. Azocar. “We’re hoping that this minimizes surgical infections, which are expensive to treat and increase the length of hospital stays.”
The doctors hope to collect enough data to review the protein shakes impact on infection rates and length of hospital stays by the Spring of 2017.
Scrubbing Away Germs
Completing the brown bag “kit” given to patients before their operation is an antibacterial soap to use while taking a shower prior to surgery. It’s another attempt to prevent infection.
“Patients like receiving the kit, complete with instructions,” said Dr. Azocar. “Hopefully, this is helping them feel empowered about their surgery. If we find it helps them get better faster and increases our patient satisfaction scores, that’s a win-win.”
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