Perioperative supplementation with immunonutrition and its impact on surgical outcome and pain in oral cavity or mandibular tumor resection; A randomized controlled study

Abstract

Objectives: The current research investigated the impact of adding immunonutrition mixture before surgery to the standard feeding regimen for patients undergoing oral cavity or mandibular tumor resections.

Methodology: This randomized double-blind controlled trial comprised 176 cancer patients undergoing resection of oral cavity or mandibular tumors. Participants were evenly divided into two groups: Group I (Immunonutrition group) got perioperative supplementation with omega-3 taken orally and L-Alanyl-L-Glutamine (Dipeptiven) administered via intravenous infusion, in addition to the standard feeding. Group C (Control group) received only standard feeding, which included a caloric distribution of protein 10-35%, fats 20-35%, and carbohydrates 45-65%. Both groups were followed for the primary outcome, set as wound infection and duration of hospital stays. The secondary outcome, included total dose of intraoperative opioids, postoperative VAS at 0 h ,4 h, 8 h and 12 h, intraoperative hemodynamics and any postoperative complications e.g., fever, neutropenia and pneumonia.

Results: A significant difference in postoperative complications in both groups was observed; wound         infection was (1.14% vs. 7.95%) for Groups I and C respectively (P = 0.03). Group I was significantly lower in fever and neutropenia vs Group C (P < 0.01). No significant difference in hospital stay, intraoperative opioid consumption, Postoperative VAS score at 0 h ,4 h, 8 h and 12 h and intraoperative HR, MAP, SBP, DBP in both groups.

Conclusion: Immunonutrition has a substantial effect in lowering the rate of postoperative complications. However, it does not affect decreasing postoperative pain or length of hospital stay.

Keywords: Perioperative Supplementation; Immunonutrition, Outcome; Pain; Oral Cavity Tumors; Mandibular Tumors

Citation: Kotb TA, El Baradie SY, Abdelwahab M, Abed SM, Saeed S, Zedan MH, Thabet T. Perioperative supplementation with immunonutrition and its impact on surgical outcome and pain in oral cavity or mandibular tumor resection; a randomized controlled study. Anaesth. pain intensive care 2024;28(6):982-989; DOI: 10.35975/apic.v28i6.2602

Received: May 23, 2024; Revised: October 14, 2024; Accepted: October 26, 2024