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Surgery is known to be associated with stress response affecting in a negative way the clinical outcome and patient experience. The stress response includes both sympathetic nervous system activation and systemic inflammatory response. The pituitary- sympathetic one leads to a number of metabolic changes as hyperglycemia, nitrogen loss and lipolysis on the other hand the systemic inflammatory response aggravates the perioperative metabolic changes. One of components of ERAS is preoperative carbohydrate load. Oral carbohydrate was associated with attenuation of the postoperative metabolic stress response. Nitrate rich drinks before exercises have a promising impact due to improving blood flow, mitochondrial efficiency, glucose uptake and the sarcoplasmic calcium handling all of which maximize resistance to fatigue and improved exercise performance.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Low-concentration carbohydrate and nitrates group (CHON group ) | Active Comparator |
| |
| Low-concentration carbohydrate group (CHO group) | Active Comparator |
| |
| W group | Placebo Comparator |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Low-concentration carbohydrate and nitrates | Drug | Patients in the CHON group will be given 400 mL of a clear carbohydrate drink (12.5 g/100 mL maltodextrin, 50 kcal/100 mL) and 2 capsules of beet root extract 1 gm on the evening before surgery (8 hours) and another 200 mL of the carbohydrate drink and 1 capsule of beet root extract 1 gm on the day of surgery, 2 h before anesthesia induction. |
| Measure | Description | Time Frame |
|---|---|---|
| The length of hospital stay (Days) | The length of hospital stay (Days) | The study end point will be 7 days from the operation or when patient will be discharged from hospital which of which will be earlier. |
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Inclusion Criteria:
Exclusion Criteria:
Patients with
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Ibrahim Mamdouh Esmat | Contact | 01001241928 | ibrahim_mamdouh@med.asu.edu.eg | |
| Tarek Mohamed Ashoor | Contact | tarekashoor@med.asu.edu.eg |
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Ain-Shams University Hospitals | Recruiting | Cairo | Egypt |
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|
| Low-concentration carbohydrate | Drug | Patients in the CHO group will be given the same carbohydrate drink in the CHON group with 2 placebo capsules with the evening drink and one with the morning drink. |
|
| Water with placebo capsules | Other | Patients in the W group will be given equivalent volume of drinking water with placebo capsules by evening and in the morning of surgery. |
|
| ID | Term |
|---|---|
| D009566 | Nitrates |
| D014867 | Water |
| ID | Term |
|---|---|
| D000838 | Anions |
| D007477 | Ions |
| D004573 | Electrolytes |
| D007287 | Inorganic Chemicals |
| D017942 | Nitric Acid |
| D017672 | Nitrogen Compounds |
| D009930 | Organic Chemicals |
| D006878 | Hydroxides |
| D000468 | Alkalies |
| D010087 | Oxides |
| D017601 | Oxygen Compounds |
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