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Preoperative oral carbohydrate therapy
Karolinska Inst, Danderyds Hosp, Dept Clin Sci, Stockholm, Sweden; Ersta Hosp, Dept Surg, Stockholm, Sweden.
Karolinska Inst, Danderyds Hosp, Dept Clin Sci, Stockholm, Sweden; Ersta Hosp, Dept Surg, Stockholm, Sweden.
Örebro University, School of Medicine, Örebro University, Sweden.ORCID iD: 0000-0003-2636-4745
2015 (English)In: Current Opinion in Anaesthesiology, ISSN 0952-7907, E-ISSN 1473-6500, Vol. 28, no 3, 364-369 p.Article, review/survey (Refereed) Published
Abstract [en]

Purpose of review: Management of the postoperative response to surgical stress is an important issue in major surgery. Avoiding preoperative fasting using preoperative oral carbohydrates (POC) has been suggested as a measure to prevent and reduce the extent to which such derangements occur. This review summarizes the current evidence and rationale for this treatment.

Recent findings: A recent review from the Cochrane Collaboration reports enhanced gastrointestinal recovery and shorter hospital stay with the use of POC with no effect on postoperative complication rates. Multiple randomized controlled trials demonstrate improved postoperative metabolic response after POC administration, including reduced insulin resistance, protein sparing, improved muscle function and preserved immune response. Cohort studies in patients undergoing major abdominal surgery have shown that the use of POC as part of an enhanced recovery after surgery protocol is a significant predictor for improved clinical outcomes.

Summary: Avoiding preoperative fasting with POC is associated with attenuated postoperative insulin resistance, improved metabolic response, enhanced perioperative well-being, and better clinical outcomes. The impact is greatest for patients undergoing major surgeries.

Place, publisher, year, edition, pages
2015. Vol. 28, no 3, 364-369 p.
Keyword [en]
insulin resistance, preoperative fasting, preoperative oral carbohydrates
National Category
Anesthesiology and Intensive Care
Research subject
Anaesthesiology
Identifiers
URN: urn:nbn:se:oru:diva-44807DOI: 10.1097/ACO.0000000000000192ISI: 000353844000022PubMedID: 25827282OAI: oai:DiVA.org:oru-44807DiVA: diva2:816415
Note

Funding Agency:

Erling-Persson Family Foundation

Nyckelfonden, Örebro, Sweden

Available from: 2015-06-03 Created: 2015-06-03 Last updated: 2016-05-27Bibliographically approved

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CiteExportLink to record
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Citation style
  • apa
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More styles
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