Preoperative Carbohydrate Drink Prior to Elective Caesarean Section

NCT ID: NCT04159948

Last Updated: 2021-08-02

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

UNKNOWN

Clinical Phase

NA

Total Enrollment

69 participants

Study Classification

INTERVENTIONAL

Study Start Date

2020-01-20

Study Completion Date

2021-08-10

Brief Summary

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Prior to caesarean section, patients should fast from solid food for 6 hours and from clear fluids for 2 hours. Carbohydrate drinks can also be consumed up to 2 hours before surgery. These drinks have been shown to improve patient well-being after surgery and may potentially improve the neonatal blood glucose level after delivery and reduce the risk of a low blood glucose level. This study aims to assess the influence of pre-operative carbohydrate drinks on blood glucose levels of the baby at delivery.

Detailed Description

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Patients recruited to the study will be randomised to one of 3 groups.

Group 1 will receive standard care as per our current practice. This includes fasting from solids for 6 hours prior to surgery and clear fluids for up to 2 hours prior to surgery.

Group 2 will receive a carbohydrate (CHO) drink preoperatively as well as adhering to standard care. Patients will be allowed to drink this CHO drink as required from admission to hospital on the morning of their surgery. They will also receive a further 400ml bolus at 2 hours prior to surgery.

Group 3 will receive an apple juice drink preoperatively as well as adhering to standard care. Patients will be allowed to drink this apple juice drink as required from admission to hospital on the morning of their surgery. They will also receive a further 400ml bolus at 2 hours prior to surgery.

Before the start of surgery, the patients non-dominant hand grip strength will be assessed using the dynamometer. Their subjective sense of thirst and hunger will be assessed. Their fasting times for food and fluids will be recorded. The patients' blood glucose will be measured from a blood sample as their intravenous cannula is inserted. The maternal urinary ketones will be measured from a urine sample upon insertion.

The neonatal blood cord glucose will be measured from both an arterial and venous cord blood sample after delivery. This will be performed by the trained anaesthesia research fellow. Should hypoglycemia be identified, the hospital's neonatal hypoglycemia algorithm will be followed appropriately.

The patients will be followed up at 24 hours by an outcome assessor blinded to the group allocation. Numerical rating scale (NRS) pain scores, postoperative nausea and vomiting and quality of recovery will be assessed at the patients beside. All neonates will be followed up to calculate admissions to neonatal unit and the number of glucose sachets required for hypoglycemia.

Conditions

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Fasting Cesarean Delivery Affecting Fetus Glucose, Low Blood

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

3 arms with equal allocation.
Primary Study Purpose

TREATMENT

Blinding Strategy

SINGLE

Outcome Assessors
Patient will not be blinded to which arm they have been allocated to. Outcome assessors will be unaware of group allocation.

Study Groups

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Water

Patients will be allowed to drink water up to 2 hours before their caesarean section.

Group Type PLACEBO_COMPARATOR

Carbohydrate drink

Intervention Type DIETARY_SUPPLEMENT

This is a commercially available "pre-op" carbohydrate drink used in enhanced recovery programmes.

Carbohydrate drink

Patients will be allowed to drink a designated carbohydrate drink up to 2 hours before their caesarean section.

Group Type ACTIVE_COMPARATOR

Carbohydrate drink

Intervention Type DIETARY_SUPPLEMENT

This is a commercially available "pre-op" carbohydrate drink used in enhanced recovery programmes.

Apple juice

Patients will be allowed to drink apple juice up to 2 hours before their caesarean section.

Group Type ACTIVE_COMPARATOR

Carbohydrate drink

Intervention Type DIETARY_SUPPLEMENT

This is a commercially available "pre-op" carbohydrate drink used in enhanced recovery programmes.

Interventions

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Carbohydrate drink

This is a commercially available "pre-op" carbohydrate drink used in enhanced recovery programmes.

Intervention Type DIETARY_SUPPLEMENT

Eligibility Criteria

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Inclusion Criteria

* Elective caesarean section for singleton pregnancy under neuraxial anaesthesia.
* Subjects able to give informed consent and willing to comply with the study protocol.
* Subjects must be greater than 18 years old.

Exclusion Criteria

* Diabetes Mellitus - including gestational diabetes.
* Known foetal abnormality.
* General anaesthesia.
* Gestation \< 37 weeks.
* Steroids received within 4 days of delivery.
* Low birth weight 2.5 kg (IUGR)
* BMI \> 40 kg/m2
Minimum Eligible Age

18 Years

Eligible Sex

FEMALE

Accepts Healthy Volunteers

Yes

Sponsors

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Coombe Women and Infants University Hospital

OTHER

Sponsor Role lead

Responsible Party

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Ruairi Irwin

Anaesthesia SpR

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Terry Tan

Role: STUDY_DIRECTOR

Head of Department of Anaesthesia CWIUH

Locations

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Coombe Women and Infants University Hospital

Dublin, , Ireland

Site Status RECRUITING

Countries

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Ireland

Central Contacts

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Ruairi Irwin

Role: CONTACT

+353877497263

Facility Contacts

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Ruairi Irwin

Role: primary

014085200

Other Identifiers

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CWIUH-CHO (16-2019)

Identifier Type: -

Identifier Source: org_study_id

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