The effect of preoperative oral carbohydrate administration on postoperative glucometabolic response, subjective well being and quality of life in patients undergoing colorectal surgery: a randomized controlled double-blind study.

Abstract

Background: Prolonged preoperative fasting may increase anxiety, insulin resistance, and surgical stress, whereas preoperative carbohydrate loading has been shown to improve metabolic response, reduce complications, and enhance recovery, as supported by ERAS protocols.

Objectives: This study aimed to examine the effects of preoperative oral carbohydrate ingestion on postoperative glucometabolic response, subjective well-being, quality of life, and surgical clinical outcomes in patients undergoing colorectal surgery.

Methods: A prospective, randomized controlled double-blind study was conducted in a hospital in the Aegean region of Türkiye, including 50 patients scheduled for elective colorectal surgery. Data were collected using a structured form that included sociodemographic information, perioperative laboratory values, subjective well-being indicators, and the SF-36 Quality of Life Scale. The intervention group received 800 mL of a carbohydrate drink until midnight and 400 mL two hours before surgery; the control group received the same volumes of water. Participants, outcome assessors, and statistical analysts were blinded to group assignments. The researcher who administered the drinks was aware of group allocation but was not involved in outcome evaluation or data analysis.

Results: The intervention group had shorter time to first flatulence (40.60 ± 4.52 vs 46.00 ± 4.22 h, p < 0.001), earlier defecation (68.64 ± 7.94 vs 81.84 ± 8.97 h, p < 0.001), earlier oral feeding (43.80 ± 4.84 vs 48.44 ± 3.87 h, p < 0.001), and shorter hospital stay (10.64 ± 1.52 vs 14.32 ± 3.69 days, p < 0.001) compared to the control group. Postoperative albumin levels were significantly higher and CRP levels significantly lower in the intervention group at 24 h. The SF-36 physical functioning score was significantly higher in the intervention group compared to the control group (82.00 ± 11.81 vs 61.40 ± 16.17, p < 0.001). No significant differences were found in insulin resistance (HOMA-IR), gastric volume, or pH between groups.

Conclusion: Preoperative oral carbohydrate intake was associated with improved clinical recovery indicators and quality of life outcomes. In particular, it contributed to earlier return of bowel function, reduced postoperative discomfort, and significantly shorter hospital stay, indicating enhanced postoperative recovery in patients undergoing colorectal surgery.

Trial registration: First registered on 30.05.2022, NCT05402592 by ClinicalTrials.gov.