Effects of preoperative double-dose oral carbohydrates in patients undergoing elective digestive system surgery: a systematic review and meta-analysis

Objective To review evidence from randomized trials assessing the effects of preoperative double-dose oral carbohydrates in patients undergoing elective digestive system surgery. Methods China Biomedical Literature Database, the Cochrane Library, Ovid Technologies, PubMed, Web of Science, Wanfang, China Science and Technology Journal Database and China National Knowledge Infrastructure were searched from inception to March 2024, with Revman5.4 for analysis. Results Fifteen trials involving 1354 patients showed that compared with the preoperative fasting or placebo group, double-dose carbohydrates improved insulin levels [mean difference (MD) = −4.14; 95%CI = −5.50, −2.78; P < .00001] and reduced insulin resistance (MD = −1.02; 95%CI = −1.48, −0.57; P < .0001). Perioperative hunger, thirst, nausea, vomiting, and PONV were mitigated, though no significant variations on blood glucose level (MD = −0.17; 95%CI = −0.45, 0.11; P = .24). Conclusion Preoperative double-dose oral carbohydrates may be a safe and feasible approach for digestive system surgery.