PMID- 33629128
OWN - NLM
STAT- MEDLINE
DCOM- 20210924
LR  - 20211123
IS  - 1435-2451 (Electronic)
IS  - 1435-2443 (Linking)
VI  - 406
IP  - 4
DP  - 2021 Jun
TI  - Effects of preoperative oral carbohydrate on postoperative discomfort in patients 
      undergoing elective surgery: a meta-analysis of randomized controlled trials.
PG  - 993-1005
LID - 10.1007/s00423-021-02110-2 [doi]
AB  - 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.
FAU - Cheng, Po-Lung
AU  - Cheng PL
AD  - School of Medicine, College of Medicine, Taipei Medical University, Taipei, 
      Taiwan.
FAU - Loh, El-Wui
AU  - Loh EW
AD  - Cochrane Taiwan, Taipei Medical University, Taipei, Taiwan.
AD  - Center for Evidence-Based Health Care, Shuang Ho Hospital, Taipei Medical 
      University, No. 291, Zhongzheng Road, Zhonghe District, New Taipei City, 23561, 
      Taiwan.
AD  - Graduate Institute of Clinical Medicine, College of Medicine, Taipei Medical 
      University, Taipei, Taiwan.
FAU - Chen, Jui-Tai
AU  - Chen JT
AD  - Department of Anesthesiology, Shuang Ho Hospital, Taipei Medical University, New 
      Taipei City, Taiwan.
AD  - Department of Anesthesiology, School of Medicine, College of Medicine, Taipei 
      Medical University, Taipei, Taiwan.
FAU - Tam, Ka-Wai
AU  - Tam KW
AUID- ORCID: 0000-0002-1994-834X
AD  - Cochrane Taiwan, Taipei Medical University, Taipei, Taiwan. 
      kelvintam@h.tmu.edu.tw.
AD  - Center for Evidence-Based Health Care, Shuang Ho Hospital, Taipei Medical 
      University, No. 291, Zhongzheng Road, Zhonghe District, New Taipei City, 23561, 
      Taiwan. kelvintam@h.tmu.edu.tw.
AD  - Division of General Surgery, Department of Surgery, School of Medicine, College 
      of Medicine, Taipei Medical University, Taipei, Taiwan. kelvintam@h.tmu.edu.tw.
AD  - Division of General Surgery, Department of Surgery, Shuang Ho Hospital, Taipei 
      Medical University, New Taipei City, Taiwan. kelvintam@h.tmu.edu.tw.
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
DEP - 20210225
PL  - Germany
TA  - Langenbecks Arch Surg
JT  - Langenbeck's archives of surgery
JID - 9808285
RN  - 0 (Carbohydrates)
SB  - IM
CIN - Langenbecks Arch Surg. 2021 Nov;406(7):2565-2566. PMID: 34275014
MH  - Adult
MH  - Carbohydrates
MH  - *Elective Surgical Procedures
MH  - *Fasting
MH  - Humans
MH  - Preoperative Care
MH  - Randomized Controlled Trials as Topic
OTO - NOTNLM
OT  - Anaesthesia
OT  - Fasting
OT  - Operation
OT  - Oral carbohydrate
OT  - Perioperative
OT  - Safety
EDAT- 2021/02/26 06:00
MHDA- 2021/09/25 06:00
CRDT- 2021/02/25 05:48
PHST- 2020/11/01 00:00 [received]
PHST- 2021/02/01 00:00 [accepted]
PHST- 2021/02/26 06:00 [pubmed]
PHST- 2021/09/25 06:00 [medline]
PHST- 2021/02/25 05:48 [entrez]
AID - 10.1007/s00423-021-02110-2 [pii]
AID - 10.1007/s00423-021-02110-2 [doi]
PST - ppublish
SO  - Langenbecks Arch Surg. 2021 Jun;406(4):993-1005. doi: 10.1007/s00423-021-02110-2. 
      Epub 2021 Feb 25.