Human body exposure to any trauma, such as surgical procedures stimulates neurohumoral and catabolic responses. This process includes; increased metabolism of proteins, carbohydrates, and lipids along with water and sodium retention, resistance to insulin, and furthermore, increased levels of blood sugar. One of the factors that has been assumed to influence postoperative complications is preoperative fasting duration.
In this double-blind, randomized clinical trial, 90 patients aged 18 to 70 years, referred for elective surgery were randomly allocated to three groups of 30. Group A (IV-CHO): Within 6 hours of fasting, this group was treated with one gram per kilogram of carbohydrate dissolved in 50 ml of normal saline and then injected. Group B (Oral-CHO): Within 6 hours of fasting, this group was treated with one gram per kilogram of carbohydrate dissolved in 50 ml of normal saline and then administered orally. Group C (Ni-CHO): Within 6 hours of fasting, 50 ml of normal saline was administrated orally in this group. Patients were requested to score their pain following the surgical procedure using a scale of 0-10 scoring (VAS). Besides, the [need for] analgesics before [transfer] to the general ward, at the end of recovery stay were recorded as well.
According to the results of our study, evaluation (and) comparison of VAS scores was significantly different among groups prior to the surgical procedure (p=0.004). Postoperative pain assessments showed significant difference among groups (p=0.002). Scheffe test showed significantly less pain score in the IV-CHO group than the oral-CHO (p=0.029) and control group (p=0.010).
Preoperative use of carbohydrate whether intravenously or orally could efficiently affect postoperative adverse effects in a positive manner while some aspects were not statistically changed to a more desirable status.