Role of Preoperative Carbohydrate Loading for Length of Hospital Stay in Elective Surgery Patient: Meta-Analysis Study
Author(s): Akhyar Hamonangan Nasution* , Tasrif Hamdi, and Bastian Lubis
Abstract
Background: Preoperative administration of oral carbohydrates reduces insulin resistance and prevents catabolic metabolism. Preoperative oral carbohydrates have also been recommended by the Enhanced Recovery after Surgery (ERAS) protocol as part of a multimodal approach in an effort to reduce length of stay in surgical patients and rates of complications.
Methods: The study design was carried out using meta-analysis randomized controlled trials (RCTs) by conducting a literature review of RCTs published in the last 5 years. Article databases were searched systematically for RCTs comparing preoperative carbohydrate administration with water, a placebo drink, or fasting. A comprehensive literature search was carried out using PubMed and Google Scholar. Then the risk ratio (RR) is calculated with a 95% confidence interval using the fixed-effects model.
Results: Some 20 trials involving 1921 participants were included. Comparison of CHO and preoperative fasting showed that preoperative low-dose and high-dose carbohydrate administration decreased postoperatively length of stay by 0.4 day. There was no significant decrease in length of stay compared with water or placebo.
Conclusion: Administration of carbohydrates before elective surgery provided a slight reduction in postoperative hospital stay compared to fasting.