The Effect of Preoperative Oral Carbohydrate Intake on Patient Outcomes

Abstract

One of the basic principles of Enhanced Recovery After Surgery (ERAS) protocols is to prevent prolonged fasting of patients with preoperative oral carbohydrate intake without increasing complication rates. The aim of this review is to investigate the effects of preoperative oral carbohydrate intake on postoperative patient outcomes. This review examines full-text meta-analyses, systematic reviews, randomized controlled studies, clinical studies and guidelines in Turkish and English languages published between 2000 and 2019 that are retrieved from databases using the keywords 'ERAS protocols', 'oral carbohydrate intake', 'morbidity', 'mortality' and 'complication'. The published guidelines suggest that clear liquid foods can be taken 2-3 hours before anesthesia (Level of Evidence A), and 400 ml of oral carbohydrate solution may be given. According to the results of a randomized controlled trial, preoperative oral carbohydrate intake reduces the length of hospital stay after surgical intervention and helps patients' bowel function return to normal in a shorter time period. Similar studies report that oral carbohydrate reduces nausea-vomiting and insulin resistance, keeps blood glucose below 180 mg/dl, and increases patient comfort. However, the current literature also presents studies reporting that preoperative oral carbohydrate intake does not have a significant effect on complication rates and patient comfort, and that there is a need for new evidence-based research. It is essential to ensure that nurses, who have an active role in all stages of the perioperative process, have access to up-to-date information on preoperative oral carbohydrate intake as a part of ERAS protocols and its effects.

Keywords

• patient outcomes
• enhanced recovery after surgery protocols
• preoperative fasting
• preoperative oral carbohydrate i̇ntake