ERAS-Based Preoperative Nutrition and Fasting in Total Knee Arthroplasty
NCT ID: NCT07336160
Last Updated: 2026-01-14
Study Results
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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RECRUITING
NA
72 participants
INTERVENTIONAL
2025-12-26
2026-09-01
Brief Summary
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Total knee arthroplasty is a commonly performed surgical procedure, particularly in older adults, and postoperative recovery may be negatively affected by surgical stress, anesthesia-related complications, dehydration, and postoperative nausea and vomiting. ERAS protocols emphasize the optimization of preoperative nutrition and hydration as key components to improve postoperative outcomes.
In this study, patients undergoing elective total knee arthroplasty will be randomly assigned to an intervention group or a control group. Patients in the intervention group will receive ERAS-based preoperative nutrition education and a standardized fasting protocol during the 24 hours prior to surgery, while patients in the control group will receive routine standard care.
Postoperative hydration status, nausea and vomiting severity, and fluid intake-output balance will be assessed and compared between the two groups. The findings of this study are expected to contribute to improving perioperative nursing care practices and enhancing patient recovery and comfort following total knee arthroplasty.
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Detailed Description
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Total knee arthroplasty is an effective and frequently performed surgical intervention, particularly among older adults with degenerative joint disease. However, perioperative stress, prolonged fasting, and anesthesia-related factors may adversely affect postoperative recovery, leading to dehydration, nausea, and vomiting. Optimizing perioperative care through evidence-based ERAS protocols is therefore essential to improve patient outcomes.
ERAS protocols promote a multidisciplinary approach aimed at reducing surgical stress and accelerating postoperative recovery. One of the core components of ERAS is the optimization of preoperative nutrition and hydration. According to evidence-based guidelines, solid foods may be consumed up to 6 hours and clear liquids up to 2 hours prior to elective surgery. This approach reduces unnecessary prolonged fasting, prevents dehydration and insulin resistance, and improves postoperative comfort without increasing anesthesia-related risks.
The study will be conducted in the orthopedic clinic of Acıbadem Altunizade Hospital. Eligible patients scheduled for elective total knee arthroplasty will be recruited and randomly assigned to either the intervention or control group using a simple randomization method. Written informed consent will be obtained from all participants prior to enrollment.
Patients in the intervention group will receive an ERAS-based preoperative nutrition education leaflet and will be instructed to follow the standardized nutrition and fasting protocol during the 24-hour preoperative period. Patients in the control group will receive routine standard preoperative care as applied in the clinic.
Data collection will include demographic and clinical characteristics, postoperative hydration status, nausea and vomiting frequency and severity, and fluid intake-output monitoring. The following validated instruments will be used: the Surgical Thirst Discomfort Scale, the Rhodes Index of Nausea, Vomiting and Retching, a numeric nausea rating scale, and fluid balance monitoring forms.
Postoperative outcomes will be assessed for both groups, including hydration status, nausea and vomiting incidence, and fluid intake-output balance. Statistical analyses will be performed using SPSS software. Appropriate parametric or non-parametric tests will be applied based on data distribution, with a significance level set at p \< 0.05.
This study aims to provide evidence on the effectiveness of ERAS-based preoperative nutrition education and fasting protocols in improving postoperative hydration and reducing nausea and vomiting, thereby supporting the development of structured, evidence-based nursing interventions in perioperative care.
Conditions
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Study Design
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RANDOMIZED
PARALLEL
TREATMENT
NONE
Study Groups
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ERAS-Based Preoperative Nutrition and Fasting Protocol Group
Participants receive ERAS-based preoperative nutrition education and an evidence-based fasting protocol during the 24 hours before total knee arthroplasty.
ERAS-Based Preoperative Nutrition Education and Fasting Protocol
A structured preoperative nutrition education program and evidence-based fasting protocol developed in accordance with ERAS guidelines, implemented during the 24 hours prior to total knee arthroplasty.
Standard Care Group
Participants receive routine preoperative care according to standard clinical practice without ERAS-based nutrition education or fasting protocol.
Standard Preoperative Care
Participants receive routine preoperative care according to standard institutional clinical practice without ERAS-based nutrition education or fasting protocol.
Interventions
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ERAS-Based Preoperative Nutrition Education and Fasting Protocol
A structured preoperative nutrition education program and evidence-based fasting protocol developed in accordance with ERAS guidelines, implemented during the 24 hours prior to total knee arthroplasty.
Standard Preoperative Care
Participants receive routine preoperative care according to standard institutional clinical practice without ERAS-based nutrition education or fasting protocol.
Eligibility Criteria
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Inclusion Criteria
* Patients scheduled for elective total knee arthroplasty.
* Patients expected to be hospitalized for at least 48 hours postoperatively.
* Ability to communicate verbally and provide informed consent.
* Patients with adequate cognitive and neurological capacity to understand study procedures.
Exclusion Criteria
* Diagnosed cognitive impairment or psychiatric disorders affecting comprehension (e.g., Alzheimer's disease, dementia, psychotic disorders).
* Acute conditions causing dehydration in the preoperative period (e.g., vomiting, diarrhea, excessive fluid loss).
* Intraoperative complications requiring intensive care unit admission.
* Postoperative follow-up shorter than 48 hours due to early discharge or transfer to another clinic.
18 Years
ALL
No
Sponsors
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Nermin Ocaktan
OTHER
Responsible Party
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Nermin Ocaktan
Assistant Professor
Principal Investigators
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Nermin Ocaktan, PhD
Role: PRINCIPAL_INVESTIGATOR
Acıbadem Mehmet Ali Aydınlar University
Locations
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Acıbadem Health Group Atakent Hospital
Istanbul, Istanbul, Turkey (Türkiye)
Countries
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Central Contacts
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Facility Contacts
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Other Identifiers
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2025-12/474
Identifier Type: -
Identifier Source: org_study_id
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