ROLE OF PRE-OPERATIVE CARBOHYDRATE LOADING IN TERMS OF INTRA-OPERATIVE BLOOD GLUCOSE LEVELS AND POST-OPERATIVE NAUSEA AND VOMITING RANDOMIZED CONTROL TRIALS

Abstract

Background:Prolonged preoperative fasting is traditionally practiced to minimize the risk of aspiration; however, it may increase surgical stress, insulin resistance, and postoperative discomfort. Recent evidence suggests that preoperative carbohydrate loading can improve metabolic stability and recovery outcomes.

Objective:This randomized controlled trial aimed to evaluate the effects of preoperative carbohydrate loading on intra-operative blood glucose levels and the incidence of postoperative nausea and vomiting (PONV) in non-diabetic patients undergoing elective surgery.

Methods: A double-blind, placebo-controlled trial was conducted over six months, enrolling 150 adult patients (ASA I–III) scheduled for elective surgery under general anesthesia. Participants were randomized into two groups: one received a 400 mL carbohydrate-rich drink containing 50 g of complex carbohydrates two hours before induction, while the control group received a placebo. Intra-operative blood glucose levels were measured at multiple time points, and PONV incidence and severity were assessed within 24 hours post-surgery. Statistical analysis was performed using repeated-measures ANOVA and chi-square tests.

Results:Baseline characteristics were comparable between groups. The carbohydrate group showed significantly higher and more stable intra-operative blood glucose levels than the placebo group (p < 0.001). The incidence of PONV was significantly lower in the carbohydrate group (18.7%) compared to the placebo group (41.3%) (p = 0.003), with fewer patients requiring rescue antiemetics (9.3% vs. 26.7%, p = 0.006). Mean post-anesthesia care unit (PACU) stay was also shorter in the carbohydrate group (p = 0.012). No major adverse events were reported.

Conclusion:Preoperative carbohydrate loading effectively stabilizes intra-operative blood glucose, reduces PONV incidence and severity, and shortens recovery duration without increasing adverse events. These findings support incorporating carbohydrate loading into Enhanced Recovery After Surgery (ERAS) protocols to optimize perioperative outcomes