Background and Goal of Study: 
Surgery, like every other damage initiates a series of reactions in the organism like the release of stress hormones and of inflammatory metabolites.
 Usually during surgery the patient is stressed, there are changes on the cascade endocrine, hyperglycaemia increase of the insulin resistance. In these conditions the organism transforms from anabolic to catabolic.
 For decades since a patient died from the aspirated gastric,  during induction anaesthesia ,there has been a rule that the patients should be sober the day of the operation. But keeping in mind the changes in our organisms while being sober, these last few years the concept of being sober has changed.
The patients can eat food 6 hours before anaesthesia and clear liquids 2 hours before  
The purpose of this study is comparing being sober and using oral preoperatory carbohydrates in the patients’ state.
Materials and Methods:This study involves the planned patients for surgery of urinary apparatus  with general anaesthesia. 
The age of them is 20-80 years old. ASA I-II.Excluded were: the patients with mellitus diabetes, septic states, ASA>3, patients who were under corticosteroid therapy, as well as those that had anamnesis for gastro-oesophageal reflux.
This survey studies  120 patients separated in two groups: a group GS 60 that as usual were sober and the other group GC 60 that 3 hours before anaesthesia took from the mouth 250 ml Sol glucose 12,5%.With the help of a questionnaire these parameters were evaluated: anxiety, hunger, inability to focus, nausea, pain, thirst, fatigue, and weakness.To compare both groups the chi square test is used.Where the value of  P<0.5 is considered statistically significant.In both groups glucose in blood was metered before anaesthesia. Hemodynamic changes during anaesthesia were monitored.
Results and Discussion:In both groups no changes were observed regarding glycemy: not in the sober group nor in the one that took the  12.5% carbohydrate  (P = 0.812). There were also no changes between the two groups in terms of intraoperative hemodynamic changes (P = 0.6), pain (P = 0.64), postoperative vomiting (P = 0.6), hospitalization (P = 0.612). Among the groups there were no changes in the type of surgery (P = 0.8), its duration (P = 0.6), gender of the patients (P= 0.725) nor of the awakening time (P = 0.6). but there were differences regarding anxiety P=0.1, hunger  P=0.05, thirst P=0.01, fatigue P=0.05, weakness P= 0.01, changes in depression as well as ability to concentrate where the value of  P= 0.01. No case of gastro-oesophageal reflux was observed at the time of induction of anaesthesia, consequently no aspiration of gastric contents.
Conclusion:The use of 12.5% carbohydrate the morning of the operation decreases preoperatory discomfort without increasing the risk of aspiration of gastric contents.
References  :Nutrition and the Elderly Surgical Patients. MOJ Surgery ,Volume 4 Issue 5 – 2017.
 
  


02 / The difference between being sober and using oral preoperatory carbohydrates in the patients’ state.