The impact of preoperative carbohydrate loading on intraoperative body temperature: a randomized controlled clinical trial

Hamamoto, Hiroki; Yamamoto, Masashi; Masubuchi, Shinsuke; Ishii, Masatsugu; Osumi, Wataru; Tanaka, Keitaro; Okuda, Jun; Uchiyama, Kazuhisa

doi:10.1007/s00464-018-6273-2

Cited by 15 publications

(13 citation statements)

References 37 publications

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“…Adequate energy is the material basis of and an inherent condition for muscle contraction, supporting the finding that oral carbohydrates promote uterine contractility and reduce vaginal bleeding. 19,20 Preoperative oral carbohydrate consumption reduces postoperative muscle loss, promotes muscle strength, 21 and facilitates early physical activities (out of bed). We recommend administering patient-controlled analgesia before the patient gets out of bed.…”

Section: Discussionmentioning

confidence: 99%

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The effect of preoperative oral carbohydrate on the time to colostrum and amount of vaginal bleeding after elective cesarean section

Chen

Liu

et al. 2022

J of Obstet and Gynaecol

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Objective: To investigate the effect of oral carbohydrate at 2 h before elective cesarean section on postoperative recovery indicators such as the time to colostrum and vaginal bleeding. Methods: Women undergoing elective cesarean section under spinal-epidural anesthesia, aged 20-40 years, with a body mass index (BMI) of 19-30 kg/m 2 and an American Society of Anesthesiology (ASA) score of II were randomized to the oral carbohydrate group (the OC group), the oral placebo group (the OP group), or the control group (the C group). The OC group underwent oral carbohydrate preloading (300 mL/bottle), the OP group orally consumed 300 mL of distilled water, and the C group was forbidden from drinking or eating on the day of the operation. The time to colostrum, vaginal bleeding, time to exhaust, and complications were recorded. Results: A total of 38 participants in the OC group, 37 in the OP group, and 37 in the C group completed the study. Compared with the OP group and the C group, the OC group produced colostrum significantly earlier, had a lower amount of 24-h vaginal bleeding, and had a higher 24-h consumption of analgesics. Compared with OP and OC groups, the C group took longer to exhaust. No significant intergroup difference was observed for any other indicator. Conclusion: Oral carbohydrates loading 2 h before elective cesarean section significantly reduces the time to produce colostrum and the amount of vaginal bleeding, which contributes to postoperative recovery.

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Section: Discussionmentioning

confidence: 99%

“…Preoperative oral carbohydrate consumption reduces postoperative muscle loss, promotes muscle strength, 21 and facilitates early physical activities (out of bed). We recommend administering patient‐controlled analgesia before the patient gets out of bed.…”

Section: Discussionmentioning

confidence: 99%

The effect of preoperative oral carbohydrate on the time to colostrum and amount of vaginal bleeding after elective cesarean section

Chen

Liu

et al. 2022

J of Obstet and Gynaecol

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“…The carbohydrate drinks before surgery improve carbohydrate uptake, utilization, storage, and protein metabolism with a 50% reduction in loss of lean body mass [ 50 ]. Preoperative carbohydrate beverages help to store glycogen in the muscle [ 13 ] and prevent the loss of lower limb mass leading to better postoperative recovery [ 19 ].…”

Section: Discussionmentioning

confidence: 99%

“…In cardiac patients, the use of ERAS protocol results in a 35% reduction in postoperative insulin doses [ 17 ]. The preoperative carbohydrate loading reduces the expression of Human leukocyte antigen (HLA)-DR on monocytes which decreases the risk of postoperative infection [ 18 ] and reduces the intraoperative core body temperature [ 19 ]. In addition, it improves muscle function because of less post-operative protein and nitrogen loss [ 20 ], which facilitates wound healing.…”

Section: Introductionmentioning

confidence: 99%

The effect of pre-operative carbohydrate loading in femur fracture: a randomized controlled trial

Chaudhary¹,

Sunuwar

Sharma³

et al. 2022

BMC Musculoskelet Disord

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Background Femur fracture is a major burden among elderly people, leading patients to be bedridden for a long time in the hospital. The body is more likely to be in a catabolic state as a result of the prolonged fasting period required for surgery, leading to an increase in insulin resistance. Pre-operative carbohydrate loading has been shown to improve postoperative outcomes in several countries. The study aimed to evaluate the effect of pre-operative carbohydrate loading in femur fracture surgery. Methods This study was single-center, hospital-based, open-label, parallel-group randomized controlled trial conducted between August 2020 and November 2021. A total of 66 participants, aged 50 years and above having femur fractures planned for surgery were included in this study and assigned to the control (n = 33) and study (n = 33) groups through computer-generated random numbers. The control group was kept fasting from midnight to the next morning as in existence while the study group was intervened with carbohydrate loading according to the Enhanced Recovery After Surgery (ERAS) protocol. The pre-operative nutritional status was identified and the postoperative outcomes were measured using the Visual Analogue Score (VAS), Cumulative Ambulatory Score (CAS), and Modified Barthel Index (MBI) scoring systems. Statistical analyses were performed using the Chi-square test and the Student’s two-sample t-test to compare the outcomes between the two groups. Results All the participants completed the study. There was a significant reduction in the average postoperative pain in the carbohydrate loading group (VAS: 4.8 (SD ± 1.8), 95% CI: 4.7–5.4) as compared to the control group (VAS: 6.1 (SD ± 2.1), 95% CI: 5.3–6.8). The average CAS showed a significant improvement in regaining the mobility function of participants in the study group (CAS: 8.1 (SD ± 2.8), 95% CI: 7.1–9.1) than that of the control group (CAS: 6.8 (SD ± 2.8), 95% CI: 5.8–7.8). The mean MBI score of the participants at the time of discharge from the hospital was higher in the study group (MBI:13.1 (SD ± 2.3), 95% CI: 12.2–13.9) compared to the control group (MBI: 11.8 (SD ± 3.1), 95% CI:10.6–12.9). Similarly, the length of hospital stay after surgery had decreased in the study group than in the control group. Conclusions The uptake of carbohydrate loading showed reduced post-operative pain, enhanced functional mobility, and decreased length of hospital stay. This study warrants larger trials to show the effect of pre-operative carbohydrate loading in a clinical setting. Trial registration NCT04838366, first registered on 09/042021 (https://clinicaltrials.gov/ct2/show/NCT04838366).

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“…It is also of interest to weigh the possible risks against the suggested benefits of preoperative carbohydrate consumption, namely attenuation of insulin resistance and lesser catabolism of lean body tissues in response to fasting and stress during and immediately after surgery. We want to highlight the following 2 important points: first, studies that measured and showed a possible benefit in postoperative glycemic control, insulin resistance, and body composition changes with preoperative carbohydrate loading come mostly from lean patients and patients with cancer; and consideration should be given that the absolute amount of lean mass-sparing through preoperative carbohydrate loading was recently measured to be ,.5 kg in nonobese patients undergoing laparoscopic colon cancer surgery [10]. Also, it is well known that the contribution of lean mass to total weight loss is inversely proportional to the initial degree of adiposity [11], making acute lean tissue wasting far less concerning in patients with obesity compared with patients with healthy weight or underweight.…”

Section: Surgery For Obesity and Related Diseases 16 (2020) E5-e7mentioning

confidence: 99%

Comment on: Employing New Enhanced Recovery Goals for Bariatric Surgery (ENERGY): A National Quality Improvement Project Utilizing the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program

Roriz-Silva

Khoraki

Browning

et al. 2020

Surgery for Obesity and Related Diseases

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The impact of preoperative carbohydrate loading on intraoperative body temperature: a randomized controlled clinical trial

Abstract: CHO had no effect on raising the intraoperative core temperature, and no negative impact on the perioperative outcome. CHO prevented the loss of lower limb muscle mass, which may lead to better postoperative recovery.

Cited by 15 publications

References 37 publications

The effect of preoperative oral carbohydrate on the time to colostrum and amount of vaginal bleeding after elective cesarean section

The effect of preoperative oral carbohydrate on the time to colostrum and amount of vaginal bleeding after elective cesarean section

The effect of pre-operative carbohydrate loading in femur fracture: a randomized controlled trial

Comment on: Employing New Enhanced Recovery Goals for Bariatric Surgery (ENERGY): A National Quality Improvement Project Utilizing the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program

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