The effect of preoperative maltodextrin administration on pulmonary function measured by spirometry and skeletal muscle strength assessed by handgrip dynamometer following gynecological laparotomy under general anesthesia

Gunawan, Chandra and Widnyana, I Made Gede and Aryabiantara, I Wayan (2025) The effect of preoperative maltodextrin administration on pulmonary function measured by spirometry and skeletal muscle strength assessed by handgrip dynamometer following gynecological laparotomy under general anesthesia. GSC Biological and Pharmaceutical Sciences, 32 (1). 093-100. ISSN 2581-3250

Background: Gynecological malignancies treated with major laparotomy are associated with pulmonary complications, reduced muscle strength, and inflammatory responses caused by surgical stress and prolonged fasting. These issues may delay recovery and increase morbidity. Preoperative carbohydrate administration within 2 hours before surgery is proposed to mitigate these effects. Methods: This double-blind randomized controlled trial involved 52 patients undergoing gynecological laparotomy with general anesthesia. Patients were randomly divided into two groups: the intervention group (receiving preoperative maltodextrin) and the control group (receiving preoperative plain water). Parameters measured included pulmonary function (FEV1 and FVC) using spirometry, handgrip strength using a dynamometer, and neutrophil-to-lymphocyte ratio (NLR). Measurements were taken preoperatively, at 24 hours postoperatively for NLR, and at 24 and 48 hours postoperatively for FEV1, FVC, and handgrip strength. Results were analyzed using parametric and nonparametric tests. Results: The intervention group exhibited a smaller decline in FEV1 and FVC at 24 hours postoperatively compared to controls, with significant FVC recovery at 48 hours (p = 0.026). Handgrip strength showed a smaller decline at 24 hours (p = 0.006) and better recovery at 48 hours (p = 0.031). NLR elevation in the intervention group was lower than in controls (p = 0.000), indicating reduced inflammatory responses. Conclusion: Preoperative maltodextrin administration effectively prevents pulmonary dysfunction, reduces muscle strength decline, and mitigates inflammatory responses in gynecological laparotomy patients. Implementation of maltodextrin is recommended in perioperative management.