The Effect of Preoperative Oral Intake of Liquid Carbohydrate on Postoperative Stress Parameters in Patients Undergoing Laparoscopic Cholecystectomy: An Experimental Study

2023 American Society of Anesthesiologists Practice Guidelines for Preoperative Fasting: Carbohydrate-containing Clear Liquids with or without Protein, Chewing Gum, and Pediatric Fasting Duration—A Modular Update of the 2017 American Society of Anesthesiologists Practice Guidelines for Preoperative Fasting

“…The body of evidence included 139 studies (adult surgical: 99 randomized controlled trials, 23–34,36–64,68–86,91,118–157 7 nonrandomized trials, 65,66,87,152,158–160 3 prospective cohort studies, 90,161,162 2 retrospective cohort studies, 163,164 1 case-control study, 165 and 2 before–after studies 67,166 ; adult nonsurgical: 1 randomized controlled trial, 167 9 crossover, 168–176 and 2 nonrandomized trials 177,178 ; pediatric surgical: 9 randomized controlled trials, 100,113,179–185 1 prospective cohort 186 ; and pediatric nonsurgical: 2 randomized controlled trial, 102,104 1 crossover, 35 and 1 prospective cohort 103 ) comparing carbohydrate-containing clear liquids (simple, complex) with water, placebo, or fasting. In the carbohydrate arms, liquids were allowed an average of 2.25 h before surgery (80% until 2 h).…”

Evaluation of carbohydrate loading on clinical results and metabolic responses in patients undergoing laparoscopic cholecystectomy

“…This indicates that carbohydrate loading is a clear advantage of surgery over fasting [ 29 ]. The results of the study by Gomus et al, showed that preoperative oral carbohydrate intake had no effect on blood glucose (p < 0.05) but reduced insulin resistance at 24 h postoperatively and serum cortisol levels [ 30 ]. Network meta-analysis showed that carbohydrate loading has minimum effect on hospital stay compared to fasting whereas incurs no benefits compared to placebo and water [ 31 ].…”

Extending the benefit of nutrition intervention beyond the operative setting

“…The traditional preoperative fasting time of 6-8 h has been modified by various international societies of anesthesiologists and nutrition [13]. The ingestion of 200-400 ml of a beverage containing carbohydrates (CHO) is not only safe, but also benefit patients by reducing stress, thirsty and insulin resistance [19,20]. Postoperative discomfort may ameliorate even in minor laparoscopic procedure such as cholecystectomy [20].…”

“…The ingestion of 200-400 ml of a beverage containing carbohydrates (CHO) is not only safe, but also benefit patients by reducing stress, thirsty and insulin resistance [19,20]. Postoperative discomfort may ameliorate even in minor laparoscopic procedure such as cholecystectomy [20]. A recent meta-analysis including 5606 patients consistently confirmed these findings, and also showed CHO drinks given 2-3 h before anesthesia may reduce LOS [21 & ].…”