A randomized trial of preoperative oral carbohydrates in abdominal surgery

BMC Anesthesiol. 2014 Oct 17;14:93. doi: 10.1186/1471-2253-14-93. eCollection 2014.

Abstract

Background: Carbohydrate-rich liquid drinks (CRLDs) have been recommended to attenuate insulin resistance by shortening the preoperative fasting interval. The aim of our study the effect of preoperative oral administration of CRLDs on the well-being and clinical status of patients.

Methods: A randomized, double blind, prospective study of patients undergoing open colorectal operations (CR) and open cholecyctectomy (CH) was conducted. Patients were divided into three groups: study, placebo, and control. Visual analogue scale (VAS) scores for seven parameters (thirst, hunger, anxiety, mouth dryness, nausea, weakness and sleep quality) were recorded and compared for two different time periods (up to 24 h postoperatively and from 36 to 48 h postoperatively). The Simplified Acute Physiology Score changes (SAPS)-II between the three groups were also studied.

Results: There were 142 patients American Society of Anesthesiology (ASA) I or II enrolled in the study (CR = 71 and CH = 71). There were no significant differences in postoperative SAPS-II scores or lengths of hospital stay (LOS) between the groups. However, in CR patients, the degree of thirst was partially improved by drinking CRLDs (P = 0.027). In CH patients, on the other hand, feelings of thirst, hunger, mouth dryness, nausea and weakness showed significant improvement (P < 0.05).

Conclusion: Oral administration of carbohydrate-rich liquid drinks (CRLDs) improves the well-being in patients undergoing CH, but the effect is less evident in patients undergoing CR. No significant improvements were seen in clinical status or in length of hospital stay in either group.

Trial registration: ANZCTR.org.au: ACTRN12614000995673 (registered on 16/09/2014).

Keywords: Carbohydrates; Fasting; Postoperative period; Preoperative use of carbohydrates; Thirst.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Abdomen / surgery*
  • Activities of Daily Living
  • Aged
  • Anesthesia Recovery Period
  • Beverages
  • Carbohydrates / therapeutic use*
  • Cholecystectomy
  • Digestive System Surgical Procedures
  • Double-Blind Method
  • Endpoint Determination
  • Female
  • Humans
  • Intraoperative Care / methods*
  • Length of Stay
  • Male
  • Middle Aged
  • Prospective Studies
  • Recovery of Function

Substances

  • Carbohydrates

Associated data

  • ANZCTR/ACTRN12614000995673