The effect of oral protein and carbohydrate solution administration on NLR, IL-6 and CRP levels in patients undergoing surgery

Abstract

Aims: To determine the effect of administering oral protein and carbohydrate solutions the C-Reactive Protein (CRP), Interleukin-6 (IL-6), and Neutrophil-Lymphocyte Ratio (NLR) in patients planned any surgery 
Methods: a double-blind, randomized clinical study, at Ulin Regional Hospital, Banjarmasin with patients planned any surgery. This research had 80 patients in total (40 subjects in the control group and 40 subjects in the intervention group). Before surgery, 200 mL of a protein and carbohydrate solution per oral was given to the intervention group, while a placebo was given to the control group. Twenty-four hours after surgery, each subject’s levels of CRP, IL-6 and NLR were measured. Statistical Package for the Social Sciences Version 29 was used to analyze the data. 
Results: NLR at 24 hours postoperatively in the intervention group was lower than in the control group, but not statistically different (8.65±4.33 vs. 7.86±4.65, p=0.308). The IL-6 level at 24 hours postoperatively in the intervention group was significantly lower than in the control group (9.49 (6.03-22.65) vs. 20.08 (11.64-50.11), p=0.011). Although not statistically different, the CRP level at 24 hours postoperatively in the intervention group was lower than in the control group (15.10 (7.20-41.60) vs. 34.70 (11.87-71.55), p=0.056). There was no difference in postoperative nausea or vomiting between the two groups.
Conclusion: Postoperative interleukin-6 levels have been demonstrated to decrease when oral protein and carbohydrate solutions are given to patients undergoing surgery; however, NLR and CRP levels have not been seen to decrease.