Effect of Preoperative Oral Carbohydrate Loading on Early Surgical Outcomes - A Randomised Controlled Study

Background Enhanced recovery after surgery (ERAS) protocols are designed to minimise the physiological stress associated with surgical procedures. A key component of these protocols is preoperative carbohydrate loading, which aims to optimise patients' metabolic status before surgery. This study investigated the impact of preoperative carbohydrate intake on early surgical outcomes and encouraged their integration into surgical practice. Methods In this randomised controlled trial, 40 patients who were scheduled for elective surgery under general anaesthesia were enrolled and divided into two groups via the sealed envelope method. The GLUC group received preoperative oral carbohydrate loading and the FAST group followed the conventional fasting guidelines. The primary outcome measured was blood glucose levels at two and 24 hours postoperatively. The secondary outcomes included serum cortisol and insulin levels at the same time points, postoperative complications classified according to the Clavien-Dindo system, and length of hospital stay. Results There were 20 participants in each group after randomisation. Statistical analysis revealed significant differences in blood glucose levels between the two groups at induction and 24 hours postoperatively (p < 0.05). Serum cortisol levels at 24 hours post surgery also significantly varied. Although the FAST group presented a incidence of surgical site infections (SSI) according to the Clavien-Dindo classification, this difference was not statistically significant. Conclusion The administration of carbohydrate-rich clear liquids up to two hours before surgery appears to be safe and may mitigate the surgical stress response. Despite the small sample size, this study lays the groundwork for larger-scale research, particularly in the Indian subcontinent, where the adoption of ERAS protocols is limited.