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Preoperative carbohydrate loading for elective surgery: a systematic review and meta-analysis

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An Erratum to this article was published on 08 September 2012

Abstract

Background and objective

It is unclear whether the preoperative administration of oral carbohydrates (CHO) is safe and effective, and therefore we herein evaluated the efficacy and adverse events associated with CHO for elective surgery.

Methods

Comprehensive searches were conducted to identify randomized controlled trials (RCTs), which evaluated preoperative CHO for elective surgery. Two reviewers independently selected the trials, extracted data, and assessed the methodological qualities and evidence levels. The data were analyzed by the RevMan 5.0 software program.

Result

CHO increased the insulin and glucose levels on the first day after surgery higher than those in overnight fasting group (fifteen RCTs) and i.v. glucose infusion group (three RCTs). The pooled results of thirteen RCTs showed greater declines in the insulin level at the induction of anesthesia and a smaller increase in the glucose level at the end of surgery, and fewer decreases in the postoperative insulin sensitivity index in the CHO group were observed as compared to the placebo group. No aspiration was observed in any of the included studies.

Conclusion

CHO appears to be safe, and may attenuate postoperative insulin resistance as compared to placebo. However, the quality of most of the published trials has been poor, and the evidence levels for most outcomes were low, so rigorous and larger RCTs are needed in the future.

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Acknowledgments

This research was funded by the academic Newcomer Award for Ph.D of Lanzhou University, but the foundation did not play any role in conducting the research, including interpreting the results.

Conflict of interest

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Authors and Affiliations

  1. Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Dong Gang West Road No. 199, Lanzhou, 730000, Gansu, China

    Lun Li, Zehao Wang, Xiangji Ying, Jinhui Tian, Kang Yi, Peng Zhang, Zhang Jing & Kehu Yang

  2. The First Clinical College of Lanzhou University, Lanzhou, 730000, Gansu, China

    Lun Li, Kang Yi, Peng Zhang & Kehu Yang

  3. The Second Clinical College of Lanzhou University, Lanzhou, 730000, Gansu, China

    Zehao Wang & Xiangji Ying

  4. Shanghai Jiao-Tong University School of Medicine Ren-ji Hospital, Shanghai, 20000, China

    Tiantian Sun

  5. Institute of Science and Technology Information of Gansu, Lanzhou, 730000, China

    Zhang Jing

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  1. Lun Li
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Correspondence to Zhang Jing.

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L. Li and Z. Wang contributed equally to this paper.

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Li, L., Wang, Z., Ying, X. et al. Preoperative carbohydrate loading for elective surgery: a systematic review and meta-analysis. Surg Today 42, 613–624 (2012). https://doi.org/10.1007/s00595-012-0188-7

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