Comparison of preoperative oral carbohydrate loading and placebo for postoperative patient comfort in laparoscopic abdominal surgeries

Over the past two decades, perioperative care has undergone a shift with the

advent of Enhanced Recovery After Surgery protocols, which

integrate evidence-based practices to reduce surgical stress, expedite

recovery, and improve overall patient outcomes. Among these

interventions, preoperative oral carbohydrate loading has emerged as a

promising nutritional strategy.

Traditionally, patients are subjected to prolonged fasting before surgery to

minimize the risk of aspiration during anesthesia. Enhancing patient comfort

or well-being is typically a significant advantage of preoperative carbohydrate

loading, with a range of variables being measured, including mouth dryness,

anxiety, fatigue, hunger, thirst, and malaise.

By preventing prolonged fasting and attenuating the stress response,

carbohydrate loading may promote gastrointestinal recovery. Moreover, there

are studies suggesting that patients who receive preoperative nutrition often

report improved comfort, reduced anxiety, and better overall satisfaction with

their surgical experience.

One of the key physiological markers impacted by preoperative carbohydrate

intake is intraoperative glycemic variability. Elevated or fluctuating blood

glucose levels during surgery have been linked to impaired immune function,

increased risk of infection, and unfavorable cardiovascular outcomes, even in

non-diabetic individuals. Stabilizing glucose levels intraoperatively is,

therefore, not only important for metabolic control but also for minimizing

surgical complications.

Postoperative nausea and vomiting is a multifactorial complication

with a high incidence following general anesthesia, often leading to delayed

oral intake, patient dissatisfaction, and unanticipated admissions. PONV

occurs due to hypoperfusion of gastric mucosa in a fasting patient and

resultant excessive serotonin release. Fluid supplementation reduces PONVby improving the mesenteric perfusion, preventing gut ischemia and

subsequent serotonin release.

Additionally, patient-centered outcomes such as postoperative nausea and

vomiting and perceived comfort are gaining increasing recognition

in the evaluation of perioperative interventions.

Enhanced Recovery After Surgery protocols focus on minimizing the surgical

stress response, shortening recovery time, and improving patient experience,

comfort is central to all of this. Carbohydrate loading is a simple, safe measure

that directly addresses this goal.

In this context, our randomized controlled trial aims to systematically

investigate the effectiveness of oral carbohydrate loading administered

preoperatively on postoperative patient comfort in laparoscopic abdominal

surgeries.