Over the past two decades, perioperative care has undergone a shift with the advent of Enhanced Recovery After Surgery protocols, which integrate evidence-based practices to reduce surgical stress, expedite recovery, and improve overall patient outcomes. Among these interventions, preoperative oral carbohydrate loading has emerged as a promising nutritional strategy. Traditionally, patients are subjected to prolonged fasting before surgery to minimize the risk of aspiration during anesthesia. Enhancing patient comfort or well-being is typically a significant advantage of preoperative carbohydrate loading, with a range of variables being measured, including mouth dryness, anxiety, fatigue, hunger, thirst, and malaise. By preventing prolonged fasting and attenuating the stress response, carbohydrate loading may promote gastrointestinal recovery. Moreover, there are studies suggesting that patients who receive preoperative nutrition often report improved comfort, reduced anxiety, and better overall satisfaction with their surgical experience.
One of the key physiological markers impacted by preoperative carbohydrate intake is intraoperative glycemic variability. Elevated or fluctuating blood glucose levels during surgery have been linked to impaired immune function, increased risk of infection, and unfavorable cardiovascular outcomes, even in non-diabetic individuals. Stabilizing glucose levels intraoperatively is, therefore, not only important for metabolic control but also for minimizing surgical complications.
Postoperative nausea and vomiting is a multifactorial complication with a high incidence following general anesthesia, often leading to delayed oral intake, patient dissatisfaction, and unanticipated admissions. PONV occurs due to hypoperfusion of gastric mucosa in a fasting patient and resultant excessive serotonin release. Fluid supplementation reduces PONV by improving the mesenteric perfusion, preventing gut ischemia and subsequent serotonin release.
Additionally, patient-centered outcomes such as postoperative nausea and vomiting and perceived comfort are gaining increasing recognition in the evaluation of perioperative interventions.
Enhanced Recovery After Surgery protocols focus on minimizing the surgical stress response, shortening recovery time, and improving patient experience, comfort is central to all of this. Carbohydrate loading is a simple, safe measure that directly addresses this goal. In this context, our randomized controlled trial aims to systematically investigate the effectiveness of oral carbohydrate loading administered preoperatively on postoperative patient comfort in laparoscopic abdominal surgeries. |