Why metabolism matters in elective orthopedic surgery: A review
Key result
Postoperative insulin resistance causes complications and delayed recovery in orthopedic surgery, but can be counteracted by preoperative carbohydrate loading, epidural analgesia, and pain control.
Population
Patients undergoing elective orthopedic surgery
Design
Review
Authors
Discussion
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Member takes
Implication
Should not yet change orthopedic perioperative protocols; hypothesis-generating from Level 5 evidence.
Structured PICO
P
Population
Patients undergoing elective orthopedic surgery
This review discusses the metabolic stress responses evoked by elective orthopedic surgery.
Limitations
- Lack of clinical studies evaluating the direct effect of postoperative insulin resistance on bone metabolism and fracture healing.
Cite This Study
Ljungqvist et al. (2007) conducted a review in Elective orthopedic surgery. Preoperative carbohydrate treatment, epidural analgesia, and optimal pain control vs. Standard preoperative fasting and care was evaluated. Postoperative insulin resistance causes complications and delayed recovery in orthopedic surgery, but can be counteracted by preoperative carbohydrate loading, epidural analgesia, and pain control.