Carb Loading

[turnupthevapor]

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Going to implement a 50 G carb load 3 hours prior to induction for healthyish patients....those that have done this did they use gatorade or grape juice (higher volumes) or the commercially available preOp fast drinks? TIA

 

[abolt18]

Going to implement a 50 G carb load 3 hours prior to induction for healthyish patients....those that have done this did they use gatorade or grape juice (higher volumes) or the commercially available preOp fast drinks? TIA

They tell them to do it with Gatorade at our institution. Sometimes patients get nauseated trying to consume the Gatorade and so they are instructed to drink as much of it as they want up to the full 20oz.

 

[sleepallday]

gatorade at my place too.

Curious to what people are doing for diabetic patients. Most papers I've found say its ok to continue with the drink. But it still gives me pause considering their diabetic meds are held or reduced

 

[Psai]

You guys are getting bought out by big gatorade

 

[GlowInTheDark]

We use Boost Breeze day

 

[DocVapor]

You guys are getting bought out by big gatorade

Well Brawndo isn't an option quite yet. I don't think it will be too much longer though.

 

[pgg]

You guys are getting bought out by big gatorade

As for me, I'm waiting for a Red Bull sponsorship. I look forward to cashing their checks, wearing their logo, and giving my patients wings.

 

[Psai]

As for me, I'm waiting for a Red Bull sponsorship. I look forward to cashing their checks, wearing their logo, and giving my patients wings.

And the chicks

 

[deleted162650]

I think I’m gonna have a blue and silver scrub cap made up.

 

[GravelRider]

Gatorade is gross. Pedialyte is where it’s at. Pedialyte is the second best hangover cure behind a good bowl of pho.

 

[fakin' the funk]

Gatorade is gross. Pedialyte is where it’s at. Pedialyte is the second best hangover cure behind a good bowl of pho.

Carne asada fries and it's not close

 

[fakin' the funk]

Curious to what people are doing for diabetic patients.

Giving it

 

[fakin' the funk]

Going to implement a 50 G carb load 3 hours prior to induction for healthyish patients....those that have done this did they use gatorade or grape juice (higher volumes) or the commercially available preOp fast drinks? TIA

We have used "G2"

 

[turnupthevapor]

Wonder if it is all that important to use malodextran vs the fructose in regular old juice

 

[deleted162650]

How bout we just run in a bag of D5 and stop all this crap??

 

[fakin' the funk]

How bout we just run in a bag of D5 and stop all this crap??

What crap

 

[PickleRickelus]

How bout we just run in a bag of D5 and stop all this crap??

Yeah sure. You can pay for it.

 

[vector2]

How bout we just run in a bag of D5 and stop all this crap??

Gastric and bowel neurohormonal response is significantly different when comparing a sugar water bolus into the stomach vs. a vein.

 

[turnupthevapor]

How bout we just run in a bag of D5 and stop all this crap??

Patients are much happier and less anxious if they are not hungry...you have to admit pt experience is important

 

[deleted162650]

What crap

The notion that somehow force feeding a sports drink shortly before surgery has some magical benefits. Didn't we have a thread not too long ago about an aspiration event after a pt was mad to chug a 32oz gatorade 2hrs before surgery.

Yeah sure. You can pay for it.

A bag of D5 LR is about the same price as a Gatorade. And are you really whining about a 3$ bag of IV fluid in the context of a 25K + operation and what will be 100K + hospital stay. 😵

Gastric and bowel neurohormonal response is significantly different when comparing a sugar water bolus into the stomach vs. a vein.

Patients are much happier and less anxious if they are not hungry...you have to admit pt experience is important

Both of things are addressed by allowing the pt to consume clears (sugar containing if you must) up to 2 hrs before surgery as current guidelines allow. Pre-op instructions should read: "If you are thirsty, you may drink Gatorade up to 2 hr before surgery." Telling patients that they have to slam a quart of fluids 2 hrs before surgery is ridiculous.

 

[DrZzZz]

"If you are thirty, you may drink Gatorade up to 2 hr before surgery." Telling patients that they have to slam a quart of fluids 2 hrs before surgery is ridiculous.

That's age-ist. Older folks deserve their fluids too.

 

[deleted162650]

fixed it*

 

[Hork Bajir]

Gastric and bowel neurohormonal response is significantly different when comparing a sugar water bolus into the stomach vs. a vein.

...This is why I run the bag of D5 directly into the OG tube

 

[turnupthevapor]

The notion that somehow force feeding a sports drink shortly before surgery has some magical benefits. Didn't we have a thread not too long ago about an aspiration event after a pt was mad to chug a 32oz gatorade 2hrs before surgery.



A bag of D5 LR is about the same price as a Gatorade. And are you really whining about a 3$ bag of IV fluid in the context of a 25K + operation and what will be 100K + hospital stay. 😵





Both of things are addressed by allowing the pt to consume clears (sugar containing if you must) up to 2 hrs before surgery as current guidelines allow. Pre-op instructions should read: "If you are thirsty, you may drink Gatorade up to 2 hr before surgery." Telling patients that they have to slam a quart of fluids 2 hrs before surgery is ridiculous.

Thanks for the reference on the previous post, I took a look at it and your right but they told patients to drink to much volume. There has never been a ERAS paper recommending 32 Oz the AM of surgery like in that example. You will see 12 to 16 oz. The 32 oz is for the night before. I have to blame those outcomes on the person who made the protocol. I do like your thought of telling the pt to stop drinking when they are not thirsty though. Thanks

 

[PickleRickelus]

The notion that somehow force feeding a sports drink shortly before surgery has some magical benefits. Didn't we have a thread not too long ago about an aspiration event after a pt was mad to chug a 32oz gatorade 2hrs before surgery.



A bag of D5 LR is about the same price as a Gatorade. And are you really whining about a 3$ bag of IV fluid in the context of a 25K + operation and what will be 100K + hospital stay. 😵





Both of things are addressed by allowing the pt to consume clears (sugar containing if you must) up to 2 hrs before surgery as current guidelines allow. Pre-op instructions should read: "If you are thirsty, you may drink Gatorade up to 2 hr before surgery." Telling patients that they have to slam a quart of fluids 2 hrs before surgery is ridiculous.

I don't know about that dude. Pretty sure Gatorades cost less then a dollar if you buy them in bulk and if you're talking about doing hundreds of procedures then that alone leads to substantial savings down the line. But it's cool you can the difference if you're down to make it rain.

 

[fakin' the funk]

The notion that somehow force feeding a sports drink shortly before surgery has some magical benefits.
...
Telling patients that they have to slam a quart of fluids 2 hrs before surgery is ridiculous.

This is straw man stuff - it's unlike you.

The encouragement of fluids up to 2hrs preop is IMO the 2nd biggest thing in the whole ERAS bundle.
(1st - early mobilization)
(3rd - opioid minimization)

 

[deleted162650]

This is straw man stuff - it's unlike you.

The encouragement of fluids up to 2hrs preop is IMO the 2nd biggest thing in the whole ERAS bundle.
(1st - early mobilization)
(3rd - opioid minimization)

I don’t disagree with encouraging fluids preop at all. I do disagree with setting some arbitrary volume that all patients are expected down preop.

In my opinion, the most important thing is actually having a protocol/bundle that everyone is paying attention to (us, surgeons, floor nurses) so patients aren’t allowed to be slugs post-op laying in bed getting q2h dilaudid boluses. What is actually in the bundle is far less important than simply having one.

 

[dhb]

(1st - early mobilization)
(3rd - opioid minimization)

3.
1.
2.