The Effect of Maltodextrin Administration on Serotonin Levels in Enhanced Recovery after Caesarean Surgery

نویسندگان

1 Doctoral Study Program in Medical and Health Sciences, Faculty of Medicine, Universitas Diponegoro, Semarang, Indonesia

2 Doctoral Study Program in Medical and Health Sciences, Faculty of Medicine, Universitas Diponegoro, Semarang, Indonesia

3 Department of Anesthesiology and Intensive Therapy, Faculty of Medicine, Universitas Diponegoro, Semarang, Indonesia

4 Department of Anesthesiology and Intensive Therapy, Faculty of Medicine, Universitas Diponegoro, Semarang, Indonesia

5 Department of Anesthesiology and Intensive Therapy, Faculty of Medicine, Universitas Diponegoro, Semarang, Indonesia

6 Doctoral Study Program in Medical and Health Sciences, Faculty of Medicine, Universitas Diponegoro, Semarang, Indonesia

7 Department of Cardiology and Vascular Medicine, Faculty of Medicine, Universitas Diponegoro, Semarang, Indonesia

8 Department of Anesthesiology and Intensive Therapy, Faculty of Medicine, Universitas Diponegoro, Semarang, Indonesia

doi
10.48309/jmcs.2025.221114
چکیده

Caesarean section (CS) is a common obstetric surgery frequently associated with insulin resistance and postoperative discomfort. Enhanced Recovery after Caesarean Surgery (ERACS) protocols, which include preoperative carbohydrate loading with maltodextrin, aims to reduce these effects. Maltodextrin improves insulin sensitivity and may enhance central serotonin synthesis, a neuromodulator involved in pain modulation. This study investigates the impact of preoperative maltodextrin administration on postoperative serotonin levels in CS patients, exploring its potential metabolic and analgesic benefits within the ERACS framework. This hospital-based randomized controlled trial was conducted at Dr. Kariadi Central General Hospital Semarang from March to April 2023, involving 40 participants. They were randomly allocated into two groups: the intervention group (maltodextrin 50 g in 400 mL of distilled water administered 2 hours pre-surgery) and the control group (no carbohydrate loading). Serum serotonin levels were measured preoperatively and two hours postoperatively using ELISA. Statistical analyses were performed using SPSS. Both groups showed no significant differences in baseline characteristics. Preoperative serotonin levels were similar (p=0.535). Postoperatively, serotonin increased significantly in the maltodextrin group (from 285.7 ± 86.3 ng/mL to 345 ± 88.1 ng/mL), while it decreased in the control group (from 281.7 ± 148.2 ng/mL to 179.7 ± 62.1 ng/mL), with a greater increase in the maltodextrin group (p=0.000). Postoperative RBG was significantly lower in the maltodextrin group compared to the control group (p=0.000). Preoperative maltodextrin administration enhances postoperative serotonin levels and glycaemic control, supporting its potential role in ERACS protocols for CS recovery.