The impact of preoperative carbohydrate loading on intraoperative body temperature: a randomized controlled clinical trial
Preoperative carbohydrate loading (CHO) is one element of the enhanced recovery after surgery protocol. No clinical trial has investigated the impact of preoperative CHO on intraoperative body temperature.
This study was a single-center, prospective, randomized controlled clinical trial involving patients undergoing laparoscopic colon cancer surgery. The primary end point was the intraoperative core temperature during surgery, which was measured at 30-min intervals for 150 min after starting surgery. The secondary end points were short-term outcomes and body composition changes.
From July 2013 to May 2014, we randomized 70 patients into the control group (n = 33) or CHO group (n = 31); six patients were excluded. The core temperature of the CHO group 90, 120, and 150 min after starting surgery was significantly lower than that of the control group (control vs. CHO, respectively: 90 min; 36.26 ± 0.41 vs. 36.05 ± 0.43 °C, p = 0.0233, 120 min; 36.30 ± 0.44 vs. 36.06 ± 0.50 °C, p = 0.0283, 150 min; 36.33 ± 0.50 vs. 36.01 ± 0.56 °C, p = 0.0186). We also found a significant difference in body weight loss (control vs. CHO, respectively: − 1.6 ± 0.8 vs. − 0.9 ± 1.4 kg, p = 0.0304) and loss of lower limb muscle mass (− 0.7 ± 0.7 vs. − 0.3 ± 0.6 kg, p = 0.0110) between the control and CHO groups, respectively.
CHO had no effect on raising the intraoperative core temperature, and no negative impact on the perioperative outcome. CHO prevented the loss of lower limb muscle mass, which may lead to better postoperative recovery.
KeywordsEnhanced recovery after surgery Preoperative carbohydrate loading Intraoperative core temperature Laparoscopic colon cancer surgery
Compliance with ethical standards
Drs. Hiroki Hamamoto, Masashi Yamamoto, Shinsuke Masubuchi, Masatsugu Ishii, Wataru Osumi, Keitaro Tanaka, Junji Okuda, and Kazuhisa Uchiyama have no conflicts of interest or financial ties to disclose.
- 4.King PM, Blazeby JM, Ewings P, Longman RJ, Kipling RM, Franks PJ, Sheffield JP, Evans LB, Soulsby M, Bulley SH, Kennedy RH (2005) The influence of an Enhanced Recovery Programme on clinical outcomes, costs and quality of life after surgery for colorectal cancer. Colorectal Dis 8(6):506–513CrossRefGoogle Scholar
- 7.Gustafsson UO, Scott MJ, Schwenk W, Demartines N, Roulin D, Francis N, McNaught CE, Macfie J, Liberman AS, Soop M, Hill A, Kennedy RH, Lobo DN, Fearon K, Ljungqvist O (2013) Guidelines for perioperative care in elective colonic surgery: enhanced recovery after surgery (ERAS®) society recommendations. World J Surg 37(2):259–284CrossRefGoogle Scholar
- 12.Feldheiser A, Aziz O, Baldini G, Cox BP, Fearon KC, Feldman LS, Gan TJ, Kennedy RH, Ljungqvist O, Lobo DN, Miller T, Radtke FF, Ruiz Garces T, Schricker T, Scott MJ, Thacker JK, Ytrebø LM, Carli F (2016) Enhanced recovery after surgery (ERAS) for gastrointestinal surgery, part 2: consensus statement for anaesthesia practice. Acta Anaesthesiol Scand 60(3):289–334CrossRefGoogle Scholar
- 22.Vlug MS, Wind J, Hollmann MW, Ubbink DT, Cense HA, Engel AF, Gerhards MF, van Wagensveld BA, van der Zaag ES, van Geloven AA, Sprangers MA, Cuesta MA, Bemelman WA (2011) Laparoscopy in combination with fast track multimodal management is the best perioperative strategy in patients undergoing colonic surgery: a randomized clinical trial (LAFA-study). Ann Surg 254(6):868–875CrossRefGoogle Scholar
- 26.Guillou PJ, Quirke P, Thorpe H, Walker J, Jayne DG, Smith AM, Heath RM, Brown JM (2005) Short-term endpoints of conventional versus laparoscopic-assisted surgery in patients with colorectal cancer (MRC CLASICC trial): multicentre, randomised controlled trial. Lancet 365(9472):1718–1726CrossRefGoogle Scholar