Key result
Preoperative oral carbohydrate loading decreased presurgical hunger (P=0.003) and thirst (P=0.032) compared to 8-hour fasting, but increased postoperative nausea.
Why the study?
Does preoperative oral carbohydrate loading improve preoperative and postoperative comfort in patients undergoing elective cholecystectomy?
RCT (n=42)
Randomized
Does preoperative oral carbohydrate loading improve preoperative and postoperative comfort in patients undergoing elective cholecystectomy?
p-value: P=0.003 and P=0.032
Preoperative oral carbohydrate loading up to 2 hours before elective cholecystectomy reduces preoperative hunger and thirst but may increase postoperative nausea.
May reduce preoperative thirst/hunger with carbohydrate loading before cholecystectomy; leaves open net comfort benefit given higher early postoperative nausea.
Background: Cholecystectomy is a widespread abdominal procedure. A period of 8-hour-fasting for this relatively rapid surgery negatively affects the patients’ comfort. Objectives: The current study aimed to evaluate the effects of the presurgical intake of carbohydrate on patients’ comfort. Materials and Methods: This prospective study was carried out on 42 cholecystectomy patients (with the American Society of Anesthesiologists grade of I-II) divided into two groups. The patients in group 1 underwent laparoscopic cholecystectomy after an 8-hour-fasting period. The subjects in group 2 received a carbohydrate-rich solution with 12.5% dextrose before the surgery (125 g of sugar melted in 1 L of water; 800 and 200 mL 8 and 2 h before the surgery, respectively). Thirst, hunger, and nausea at the 9th preoperative hour and 30 min before the surgery in addition to nausea and vomiting at the 2nd, 8th, and 24th postoperative hours were assessed in both groups. Results: The mean age and body mass index (BMI) values of the patients were 48.38±12.68 years and 29.85±5.20 kg/m², respectively. The mean operational time was 36.5 min (range: 26-114 min). No difference was observed between the two groups in terms of age, BMI, and operational time. The investigation 30 min before cholecystectomy revealed that the rates of hungry and thirsty patients were higher in group 1, compared to those reported for group 2 (P=0.003 and P=0.032). Nevertheless, at the 2nd and 8th postoperative hours, the rate of patients complaining of nausea were higher in group 2 in comparison to that of group 1 (P=0.048 and P=0.014). Conclusions: It is suggested that the intake of carbohydrate-rich fluids up to the preoperative 2nd hour decreased presurgical hunger/thirst. The results of this study are in line with the findings of previous studies. It is believed that the intake of CHO-rich solutions up to 2 h before surgery may provide comfort by decreasing hunger/thirst. Nevertheless, it is necessary to take into account a potential rise in a feeling of nausea among these patients.
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Gök et al. (2020) conducted an RCT in Elective cholecystectomy (n=42). Preoperative oral carbohydrate loading vs. 8-hour fasting was evaluated on Rates of hungry and thirsty patients 30 min before cholecystectomy (p=P=0.003 and P=0.032). Preoperative oral carbohydrate loading decreased presurgical hunger (P=0.003) and thirst (P=0.032) compared to 8-hour fasting, but increased postoperative nausea.
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