Skip to main content
SpringerLink
Log in

Effects of preoperative oral carbohydrate on postoperative discomfort in patients undergoing elective surgery: a meta-analysis of randomized controlled trials

  • Systematic Reviews and Meta-analyses
  • Published:
Langenbeck's Archives of Surgery Aims and scope Submit manuscript

Abstract

Purpose

Fasting is a standard preoperative procedure performed to prevent vomiting and pulmonary aspiration during anaesthesia and surgery. However, fasting can cause postoperative physical and psychological discomfort. Intake of oral carbohydrate (CHO) may mimic the intake of food, which prevents postoperative discomfort. We conducted a meta-analysis to evaluate the effect and safety of preoperative oral CHO in adult surgical patients.

Methods

Randomized controlled trials (RCTs) were searched for in the PubMed, EMBASE, and Cochrane Library databases. A meta-analysis was performed to calculate a pooled effect size by using random-effects models. The satisfaction outcomes were mouth dryness, hunger, thirst, pain severity, duration of hospitalization, homeostatic model assessment for insulin resistance (HOMA-IR), and the incidence of postoperative nausea and vomiting. The safety outcomes were the incidence of aspiration and infection.

Results

In total, 57 RCTs involving 5606 patients were included. The outcomes of mouth dryness, thirst, hunger, and pain were assessed by a 10-point visual analogue scale (0 = best, 10 = worst). The severity of mouth dryness (weighted mean difference [WMD]: −1.26, 95% CI: −2.36 to −0.15), thirst (WMD: −1.36, 95% CI: −2.05 to −0.67), hunger (WMD: −1.66, 95% CI: −2.53 to −0.80), pain (WMD: −0.68, 95% CI: −1.01 to −0.35), duration of hospitalization (WMD: −0.39 day, 95% CI: −0.66 to −0.12), and HOMA-IR (WMD: −1.80, 95% CI: −2.84 to −0.76) were significantly lower in the CHO group than in the control group. The incidence of postoperative nausea and vomiting did not differ between the CHO and control groups. No aspiration was recorded in any of the groups.

Conclusions

Preoperative CHO can alleviate patient’s discomfort without safety concerns. Surgeons and anaesthesiologists should strongly promote preoperative CHO as a strategy to enhance recovery after surgery protocols.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6

Similar content being viewed by others

References

  1. Jeffrey LA, Madhulika A, Richard TC, Charles JC, David GN, Mark AW (2017) Practice guidelines for preoperative fasting and the use of pharmacologic agents to reduce the risk of pulmonary aspiration: application to healthy patients undergoing elective procedures: an updated report by the American Society of Anesthesiologists Task Force on Preoperative Fasting and the Use of Pharmacologic Agents to Reduce the Risk of Pulmonary Aspiration. Anesthesiology 126:376–393. https://doi.org/10.1097/ALN.0000000000001452

    Article  Google Scholar 

  2. Nygren J (2006) The metabolic effects of fasting and surgery. Best Pract Res Clin Anaesthesiol 20(3):429–438. https://doi.org/10.1016/j.bpa.2006.02.004

    Article  CAS  PubMed  Google Scholar 

  3. Noba L, Wakefield A (2019) Are carbohydrate drinks more effective than preoperative fasting: a systematic review of randomised controlled trials. J Clin Nurs 28(17-18):3096–3116. https://doi.org/10.1111/jocn.14919

    Article  PubMed  Google Scholar 

  4. Gianotti L, Biffi R, Sandini M, Marrelli D, Vignali A, Caccialanza R, Viganò J, Sabbatini A, Di Mare G, Alessiani M, Antomarchi F, Valsecchi MG, Bernasconi DP (2018) Preoperative oral carbohydrate load versus placebo in major elective abdominal surgery (PROCY): a randomized, placebo-controlled, multicenter, phase III trial. Ann Surg 267(4):623–630. https://doi.org/10.1097/SLA.0000000000002325

    Article  PubMed  Google Scholar 

  5. Henriksen MG, Hessov I, Dela F, Vind Hansen H, Haraldsted V, Rodt SÅ (2003) Effects of preoperative oral carbohydrates and peptides on postoperative endocrine response, mobilization, nutrition and muscle function in abdominal surgery. Acta Anaesthesiol Scand 47(2):191–199. https://doi.org/10.1034/j.1399-6576.2003.00047.x

  6. Mathur S, Plank LD, McCall JL, Shapkov P, McIlroy K, Gillanders LK, Merrie AE, Torrie JJ, Pugh F, Koea JB, Bissett IP, Parry BR (2010) Randomized controlled trial of preoperative oral carbohydrate treatment in major abdominal surgery. Br J Surg 97(4):485–494. https://doi.org/10.1002/bjs.7026

    Article  CAS  PubMed  Google Scholar 

  7. Smith MD, McCall J, Plank L, Herbison GP, Soop M, Nygren J (2014) Preoperative carbohydrate treatment for enhancing recovery after elective surgery. Cochrane Database Syst Rev 8:CD009161. https://doi.org/10.1002/14651858.CD009161.pub2

  8. Higgins JPT, Green S. Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0 [updated 2011]. The Cochrane Collaboration 2011, available from www.cochrane-handbook.org.

  9. Liberati A, Altman DG, Tetzlaff J, Mulrow C, Gøtzsche PC, Ioannidis JP, Clarke M, Devereaux PJ, Kleijnen J, Moher D (2009) The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: explanation and elaboration. J Clin Epidemiol 62(10):e1–e34. https://doi.org/10.1016/j.jclinepi.2009.06.006

    Article  PubMed  Google Scholar 

  10. Hozo SP, Djulbegovic B, Hozo I (2005) Estimating the mean and variance from the median, range, and the size of a sample. BMC Med Res Methodol 5:13. https://doi.org/10.1186/1471-2288-5-13

    Article  PubMed  PubMed Central  Google Scholar 

  11. DerSimonian R, Laird N (1986) Meta-analysis in clinical trials. Control Clin Trials 7(3):177–188. https://doi.org/10.1016/0197-2456(86)90046-2

    Article  CAS  PubMed  Google Scholar 

  12. An GQ, Zhao XL, Gao YC, Wang GY, Yu YM (2008) Effects of preoperative carbohydrate loading on the changes in serum tumor necrosis factor receptors 1 and 2 and insulin resistance in patients of colon carcinoma. Zhonghua Yi Xue Za Zhi 88(29):2041–2044

    CAS  PubMed  Google Scholar 

  13. Aronsson A, Al-Ani NA, Brismar K, Hedström M (2009) A carbohydrate-rich drink shortly before surgery affected IGF-I bioavailability after a total hip replacement. A double-blind placebo controlled study on 29 patients. Aging Clin Exp Res 21(2):97–101. https://doi.org/10.1007/BF03325216

    Article  CAS  PubMed  Google Scholar 

  14. Çakar E, Yilmaz E, Çakar E, Baydur H (2017) The effect of preoperative oral carbohydrate solution intake on patient comfort: a randomized controlled study. J Perianesth Nurs 32(6):589–599. https://doi.org/10.1016/j.jopan.2016.03.008

    Article  PubMed  Google Scholar 

  15. Canbay Ö, Adar S, Karagöz AH, Çelebi N, Bilen CY (2014) Effect of preoperative consumption of high carbohydrate drink (Pre-Op) on postoperative metabolic stress reaction in patients undergoing radical prostatectomy. Int Urol Nephrol 46(7):1329–1333. https://doi.org/10.1007/s11255-013-0612-y

    Article  CAS  PubMed  Google Scholar 

  16. Doo AR, Hwang H, Ki MJ, Lee JR, Kim DC (2018) Effects of preoperative oral carbohydrate administration on patient well-being and satisfaction in thyroid surgery. Korean J Anesthesiol 71(5):394–400. https://doi.org/10.4097/Kja.d.18.27143

  17. Feguri GR, Lima PR, Lopes AM, Roledo A, Marchese M, Trevisan M, Ahmad H, Freitas BB, Aguilar-Nascimento JE (2012) Clinical and metabolic results of fasting abbreviation with carbohydrates in coronary artery bypass graft surgery. Rev Bras Cir Cardiovasc 27(1):7–17. https://doi.org/10.5935/1678-9741.20120004

    Article  PubMed  Google Scholar 

  18. Hausel J, Nygren J, Lagerkranser M, Hellström PM, Hammarqvist F, Almström C, Lindh A, Thorell A, Ljungqvist O (2001) A carbohydrate-rich drink reduces preoperative discomfort in elective surgery patients. Anesth Analg 93(5):1344–1350. https://doi.org/10.1097/00000539-200111000-00063

    Article  CAS  PubMed  Google Scholar 

  19. Hausel J, Nygren J, Thorell A, Lagerkranser M, Ljungqvist O (2005) Randomized clinical trial of the effects of oral preoperative carbohydrates on postoperative nausea and vomiting after laparoscopic cholecystectomy. Br J Surg 92(4):415–421. https://doi.org/10.1002/bjs.4901

    Article  CAS  PubMed  Google Scholar 

  20. Itou K, Fukuyama T, Sasabuchi Y, Yasuda H, Suzuki N, Hinenoya H, Kim C, Sanui M, Taniguchi H, Miyao H, Seo N, Takeuchi M, Iwao Y, Sakamoto A, Fujita Y, Suzuki T (2012) Safety and efficacy of oral rehydration therapy until 2 h before surgery: a multicenter randomized controlled trial. J Anesth 26(1):20–27. https://doi.org/10.1007/s00540-011-1261-x

    Article  PubMed  Google Scholar 

  21. Lee JS, Song Y, Kim JY, Park JS, Yoon DS (2018) Effects of preoperative oral carbohydrates on quality of recovery in laparoscopic cholecystectomy: a randomized, double blind, placebo-controlled trial. World J Surg 42(10):3150–3157. https://doi.org/10.1007/s00268-018-4717-4

    Article  PubMed  Google Scholar 

  22. Özdemir F, Eti Z, Dinçer P, Yilmaz Göǧüş F, Bekiroǧlu N (2011) The effect of preoperative oral carbohydrate loading on stress response in patients undergoing major or minor surgery. Turkiye Klinikleri J Med Sci 31(6):1392–1400. https://doi.org/10.5336/medsci.2010-20548

    Article  Google Scholar 

  23. Rapp-Kesek D, Stridsberg M, Andersson LG, Berne C, Karlsson T (2007) Insulin resistance after cardiopulmonary bypass in the elderly patient. Scand Cardiovasc J 41(2):102–108. https://doi.org/10.1080/14017430601050355

    Article  CAS  PubMed  Google Scholar 

  24. Sada F, Krasniqi A, Hamza A, Gecaj-Gashi A, Bicaj B, Kavaja F (2014) A randomized trial of preoperative oral carbohydrates in abdominal surgery. BMC anesthesiology 14:93. https://doi.org/10.1186/1471-2253-14-93

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  25. Şavluk ÖF, Kuşçu MA, Güzelmeriç F, Gürcü ME, Erkılınç A, Çevirme D, Oğuş H, Koçak T (2017) Do preoperative oral carbohydrates improve postoperative outcomes in patients undergoing coronary artery bypass grafts? Turk J Med Sci 47(6):1681–1686. https://doi.org/10.3906/sag-1703-19

    Article  CAS  PubMed  Google Scholar 

  26. Singh BN, Dahiya D, Bagaria D, Saini V, Kaman L, Kaje V, Vagadiya A, Sarin S, Edwards R, Attri V, Jain K (2015) Effects of preoperative carbohydrates drinks on immediate postoperative outcome after day care laparoscopic cholecystectomy. Surg Endosc 29(11):3267–3272. https://doi.org/10.1007/s00464-015-4071-7

    Article  PubMed  Google Scholar 

  27. Singh M, Chaudhary M, Vashistha A, Kaur G (2015) Evaluation of effects of a preoperative 2-hour fast with glutamine and carbohydrate rich drink on insulin resistance in maxillofacial surgery. J Oral Biol Craniofac Res 5(1):34–39. https://doi.org/10.1016/j.jobcr.2015.02.006

    Article  PubMed  PubMed Central  Google Scholar 

  28. Sio CA, Jung K, Kang SB, Kim DW, Oh HK, Yoon M (2015) The evaluation of preoperative oral carbohydrate-rich solution effects on insulin resistance in patients undergoing colectomy. J Clin Nutr 7(2):62–67. https://doi.org/10.15747/jcn.2015.7.2.62

  29. Wang ZG, Wang Q, Wang WJ, Qin HL (2010) Randomized clinical trial to compare the effects of preoperative oral carbohydrate versus placebo on insulin resistance after colorectal surgery. Br J Surg 97(3):317–327. https://doi.org/10.1002/bjs.6963

  30. Wang Y, Zhu Z, Li H, Sun Y, Xie G, Cheng B, Ji F, Fang X (2019) Effects of preoperative oral carbohydrates on patients undergoing ESD surgery under general anaesthesia: a randomized control study. Medicine (Baltimore) 98(20):e15669. https://doi.org/10.1097/MD.0000000000015669

    Article  Google Scholar 

  31. Wendling AL, Byun SY, Koenig M, Vasilopoulos T (2020) Impact of oral carbohydrate consumption prior to cesarean delivery on preoperative well-being: a randomized interventional study. Arch Gynecol Obstet 301(1):179–187. https://doi.org/10.1007/s00404-020-05455-z

    Article  CAS  PubMed  Google Scholar 

  32. Yagci G, Can MF, Ozturk E, Dag B, Ozgurtas T, Cosar A, Tufan T (2008) Effects of preoperative carbohydrate loading on glucose metabolism and gastric contents in patients undergoing moderate surgery: a randomized, controlled trial. Nutrition 24(3):212–216. https://doi.org/10.1016/j.nut.2007.11.003

    Article  CAS  PubMed  Google Scholar 

  33. Yagmurdur H, Gunal S, Yildiz H, Gulec H, Topkaya C (2011) The effects of carbohydrate-rich drink on perioperative discomfort, insulin response and arterial pressure in spinal aesthesia. J Res Med Sci 16(11):1483–1489

    PubMed  PubMed Central  Google Scholar 

  34. Yang Y, Yan-Bing Z, Xue-Long J, Dong C, Zhi-Hao W (2012) Effects and safety of preoperative oral carbohydrate in radical distal gastrectomy–a randomized clinical trial. J Cancer Sci Ther 4(5):116–119. https://doi.org/10.4172/1948-5956.1000123

    Article  CAS  Google Scholar 

  35. Yilmaz N, Cekmen N, Bilgin F, Erten E, Özhan MÖ, Coşar A (2013) Preoperative carbohydrate nutrition reduces postoperative nausea and vomiting compared to preoperative fasting. J Res Med Sci 18(10):827–832

    PubMed  PubMed Central  Google Scholar 

  36. Yuill KA, Richardson RA, Davidson HI, Garden OJ, Parks RW (2005) The administration of an oral carbohydrate-containing fluid prior to major elective upper-gastrointestinal surgery preserves skeletal muscle mass postoperatively—a randomized clinical trial. Clin Nutr 24(1):32–37. https://doi.org/10.1016/j.clnu.2004.06.009

  37. Asakura A, Mihara T, Goto T (2015) The effect of preoperative oral carbohydrate or oral rehydration solution on postoperative quality of recovery: a randomized, controlled clinical trial. PLoS One 10(8):e0133309. https://doi.org/10.1371/journal.pone.0133309

  38. Breuer JP, von Dossow V, von Heymann C, Griesbach M, von Schickfus M, Mackh E, Hacker C, Elgeti U, Konertz W, Wernecke KD, Spies CD (2006) Preoperative oral carbohydrate administration to ASA III-IV patients undergoing elective cardiac surgery. Anesth Analg 103(5):1099–1108. https://doi.org/10.1213/01.ane.0000237415.18715.1d

  39. Çeliksular MC, Saraçoğlu A, Yentür E (2016) The influence of oral carbohydrate solution intake on stress response before total hip replacement surgery during epidural and general anaesthesia. Turk J Anaesthesiol Reanim 44(3):117–123. https://doi.org/10.5152/TJAR.2016.65265

    Article  PubMed  PubMed Central  Google Scholar 

  40. Chen J, Cheng L, Xie Z, Li Z (2015) Impact of preoperative oral liquid carbohydrate on postoperative insulin resistance in gastric cancer patients and its associated study. Zhonghua Wei Chang Wai Ke Za Zhi 18(12):1256–1260

    PubMed  Google Scholar 

  41. Dilmen OK, Yentur E, Tunali Y, Balci H, Bahar M (2017) Does preoperative oral carbohydrate treatment reduce the postoperative surgical stress response in lumbar disc surgery? Clin Neurol Neurosurg 153:82–86. https://doi.org/10.1016/j.clineuro.2016.12.016

  42. Faria MS, de Aguilar-Nascimento JE, Pimenta OS, Alvarenga LC, Dock-Nascimento DB, Slhessarenko N (2009) Preoperative fasting of 2 hours minimizes insulin resistance and organic response to trauma after video-cholecystectomy: a randomized, controlled, clinical trial. World J Surg 33(6):1158–1164. https://doi.org/10.1007/s00268-009-0010-x

    Article  PubMed  Google Scholar 

  43. Helminen H, Viitanen H, Sajanti J (2009) Effect of preoperative intravenous carbohydrate loading on preoperative discomfort in elective surgery patients. Eur J Anaesthesiol 26(2):123–127. https://doi.org/10.1097/EJA.0b013e328319be16

    Article  CAS  PubMed  Google Scholar 

  44. Järvelä K, Maaranen P, Sisto T (2008) Pre-operative oral carbohydrate treatment before coronary artery bypass surgery. Acta Anaesthesiol Scand 52(6):793–797. https://doi.org/10.1111/j.1399-6576.2008.01660.x

    Article  CAS  PubMed  Google Scholar 

  45. Karlsson A, Wendel K, Polits S, Gislason H, Hedenbro JL (2016) Preoperative nutrition and postoperative discomfort in an ERAS setting: a randomized study in gastric bypass surgery. Obes Surg 26(4):743–748. https://doi.org/10.1007/s11695-015-1848-7

  46. Kaska M, Grosmanová T, Havel E, Hyspler R, Petrová Z, Brtko M, Bares P, Bares D, Schusterová B, Pyszková L, Tosnerová V, Sluka M (2010) The impact and safety of preoperative oral or intravenous carbohydrate administration versus fasting in colorectal surgery–a randomized controlled trial. Wien Klin Wochenschr 122(1-2):23–30. https://doi.org/10.1007/s00508-009-1291-7

    Article  CAS  PubMed  Google Scholar 

  47. Ljunggren S, Hahn RG (2012) Oral nutrition or water loading before hip replacement surgery; a randomized clinical trial. Trials 13:97. https://doi.org/10.1186/1745-6215-13-97

    Article  PubMed  PubMed Central  Google Scholar 

  48. Melis GC, van Leeuwen PA, von Blomberg-van der Flier BM, Goedhart-Hiddinga AC, Uitdehaag BM, Strack van Schijndel RJ, Wuisman PI, van Bokhorst-de van der Schueren MA (2006) A carbohydrate-rich beverage prior to surgery prevents surgery-induced immunodepression: a randomized, controlled, clinical trial. JPEN J Parenter Enteral Nutr 30(1):21–26. https://doi.org/10.1177/014860710603000121

    Article  PubMed  Google Scholar 

  49. Noblett SE, Watson DS, Huong H, Davison B, Hainsworth PJ, Horgan AF (2006) Pre-operative oral carbohydrate loading in colorectal surgery: a randomized controlled trial. Colorectal Dis 8(7):563–569. https://doi.org/10.1111/j.1463-1318.2006.00965.x

  50. Pędziwiatr M, Pisarska M, Matłok M, Major P, Kisielewski M, Wierdak M, Natkaniec M, Budzyński P, Rubinkiewicz M, Budzyński R (2015) Randomized clinical trial to compare the effects of preoperative oral carbohydrate loading versus placebo on insulin resistance and cortisol level after laparoscopic cholecystectomy. Pol Przegl Chir 87(8):402–408. https://doi.org/10.1515/pjs-2015-0079

  51. Protic A, Turina D, Matanić D, Spanjol J, Zuvic-Butorac M, Sustic A (2010) Effect of preoperative feeding on gastric emptying following spinal anaesthesia: a randomized controlled trial. Wien Klin Wochenschr 122(1-2):50–53. https://doi.org/10.1007/s00508-009-1301-9

    Article  PubMed  Google Scholar 

  52. Tran S, Wolever TM, Errett LE, Ahn H, Mazer CD, Keith M (2013) Preoperative carbohydrate loading in patients undergoing coronary artery bypass or spinal surgery. Anesth Analg 117(2):305–313. https://doi.org/10.1213/ANE.0b013e318295e8d1

  53. Yang P, Feng X, Niu LJ, Yang DJ, Huang WQ, Huang XQ (2010) Effects of preoperative oral glucose on perioperative insulin resistance and plasma proteins of intestinal surgery. Zhonghua Wei Chang Wai Ke Za Zhi 13(11):814–817

    PubMed  Google Scholar 

  54. Yildiz H, Gunal SE, Yilmaz G, Yucel S (2013) Oral carbohydrate supplementation reduces preoperative discomfort in laparoscopic cholecystectomy. J Invest Surg 26(2):89–95. https://doi.org/10.3109/08941939.2012.699998

    Article  PubMed  Google Scholar 

  55. Webster J, Osborne SR, Gill R, Chow CF, Wallin S, Jones L, Tang A (2014) Does preoperative oral carbohydrate reduce hospital stay? A randomized trial. AORN J 99(2):233–242. https://doi.org/10.1016/j.aorn.2013.12.003

    Article  PubMed  Google Scholar 

  56. Harsten A, Hjartarson H, Toksvig-Larsen S (2012) Total hip arthroplasty and perioperative oral carbohydrate treatment: a randomized, double-blind, controlled trial. Eur J Anaesthesiol 29(6):271–274. https://doi.org/10.1097/EJA.0b013e3283525ba9

  57. Bisgaard T, Kristiansen VB, Hjortsø NC, Jacobsen LS, Rosenberg J, Kehlet H (2004) Randomized clinical trial comparing an oral carbohydrate beverage with placebo before laparoscopic cholecystectomy. Br J Surg 91(2):151–158. https://doi.org/10.1002/bjs.4412

    Article  CAS  PubMed  Google Scholar 

  58. Raksakietisak M, Chinachoti T, Iamaroon A, Thabpenthai Y, Halilamien P, Siriratwarangkul S, Watanitanon A (2014) Oral rehydration with 10% carbohydrate drink for preventing postoperative nausea and vomiting (PONV) after low dose of spinal morphine. J Med Assoc Thai 97(5):530–535

    PubMed  Google Scholar 

  59. Rizvanović N, Nesek Adam V, Čaušević S, Dervišević S, Delibegović S (2019) A randomized controlled study of preoperative oral carbohydrate loading versus fasting in patients undergoing colorectal surgery. Int J Colorectal Dis 34(9):1551–1561. https://doi.org/10.1007/s00384-019-03349-4

    Article  PubMed  Google Scholar 

  60. Lauwick SM, Kaba A, Maweja S, Hamoir EE, Joris JL (2009) Effects of oral preoperative carbohydrate on early postoperative outcome after thyroidectomy. Acta Anaesthesiol Belg 60(2):67–73

    CAS  PubMed  Google Scholar 

  61. Tsutsumi R, Kakuta N, Kadota T, Oyama T, Kume K, Hamaguchi E, Niki N, Tanaka K, Tsutsumi YM (2016) Effects of oral carbohydrate with amino acid solution on the metabolic status of patients in the preoperative period: a randomized, prospective clinical trial. J Anesth 30(5):842–849. https://doi.org/10.1007/s00540-016-2217-y

    Article  PubMed  PubMed Central  Google Scholar 

  62. Jones C, Kelliher L, Dickinson M, Riga A, Worthington T, Scott MJ, Vandrevala T, Fry CH, Karanjia N, Quiney N (2013) Randomized clinical trial on enhanced recovery versus standard care following open liver resection. Br J Surg 100(8):1015–1024. https://doi.org/10.1002/bjs.9165

    Article  CAS  PubMed  Google Scholar 

  63. Lidder P, Thomas S, Fleming S, Hosie K, Shaw S, Lewis S (2013) A randomized placebo controlled trial of preoperative carbohydrate drinks and early postoperative nutritional supplement drinks in colorectal surgery. Colorectal Dis 15(6):737–745. https://doi.org/10.1111/codi.12130

    Article  CAS  PubMed  Google Scholar 

  64. Liu B, Wang Y, Liu S, Zhao T, Zhao B, Jiang X, Ye L, Zhao L, Lv W, Zhang Y, Zheng T, Xue Y, Chen L, Chen L, Wu Y, Li Z, Yan J, Wang S, Sun X, Gao G, Qu Y, He S (2019) A randomized controlled study of preoperative oral carbohydrate loading versus fasting in patients undergoing elective craniotomy. Clin Nutr 38(5):2106–2112. https://doi.org/10.1016/j.clnu.2018.11.008

    Article  CAS  PubMed  Google Scholar 

  65. Dock-Nascimento DB, de Aguilar-Nascimento JE, Magalhaes Faria MS, Caporossi C, Slhessarenko N, Waitzberg DL (2012) Evaluation of the effects of a preoperative 2-hour fast with maltodextrine and glutamine on insulin resistance, acute-phase response, nitrogen balance, and serum glutathione after laparoscopic cholecystectomy: a controlled randomized trial. JPEN J Parenter Enteral Nutr 36(1):43–52. https://doi.org/10.1177/0148607111422719

    Article  CAS  PubMed  Google Scholar 

  66. Apfel CC, Heidrich FM, Jukar-Rao S, Jalota L, Hornuss C, Whelan RP, Zhang K, Cakmakkaya OS (2012) Evidence-based analysis of risk factors for postoperative nausea and vomiting. Br J Anaesth 109(5):742–753. https://doi.org/10.1093/bja/aes276

  67. Nazaré MSLD, Silva JAMG, Navega MT, Fagnello-Navega FR (2014) Comparison of pain threshold and duration of pain perception in men and women of different ages. Fisioter Mov 27(1):77–84. https://doi.org/10.1590/0103-5150.027.001.AO08

Download references

Acknowledgements

We acknowledge Wallace Academic Editing for editing this manuscript.

Author information

Authors and Affiliations

  1. School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan

    Po-Lung Cheng

  2. Cochrane Taiwan, Taipei Medical University, Taipei, Taiwan

    El-Wui Loh & Ka-Wai Tam

  3. Center for Evidence-Based Health Care, Shuang Ho Hospital, Taipei Medical University, No. 291, Zhongzheng Road, Zhonghe District, New Taipei City, 23561, Taiwan

    El-Wui Loh & Ka-Wai Tam

  4. Graduate Institute of Clinical Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan

    El-Wui Loh

  5. Department of Anesthesiology, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan

    Jui-Tai Chen

  6. Department of Anesthesiology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan

    Jui-Tai Chen

  7. Division of General Surgery, Department of Surgery, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan

    Ka-Wai Tam

  8. Division of General Surgery, Department of Surgery, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan

    Ka-Wai Tam

Authors
  1. Po-Lung Cheng
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. El-Wui Loh
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Jui-Tai Chen
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Ka-Wai Tam
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

Po-Lung Cheng: This author helped to extract, analyse, and interpret data and wrote the first draft; El-Wui Loh: This author helped to extract, analyse, and interpret data and wrote the first draft; Jui-Tai Chen: This author helped to extract, analyse, and interpret data; Ka-Wai Tam: This author helped to devise and design the study and extract, analyse, and interpret data. All authors contributed to subsequent versions and approved the final article.

Corresponding author

Correspondence to Ka-Wai Tam.

Ethics declarations

Ethics approval

This article does not contain any studies with human participants or animals performed by any of the authors.

Conflict of interest

All authors declare no conflict of interest.

Additional information

Publisher’s note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Supplementary Information

Supplemental Figure 1

(DOC 52 kb)

Supplemental Figure 2

Forest plot of CHO vs. control. Outcome: HOMA-IR (DOC 69.5 kb)

ESM 1

(DOC 174 kb)

ESM 2

(DOC 117 kb)

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Cheng, PL., Loh, EW., Chen, JT. et al. Effects of preoperative oral carbohydrate on postoperative discomfort in patients undergoing elective surgery: a meta-analysis of randomized controlled trials. Langenbecks Arch Surg 406, 993–1005 (2021). https://doi.org/10.1007/s00423-021-02110-2

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00423-021-02110-2

Keywords

Search

Navigation