The effects of honey solution on postoperative stress, gastric motility, and patient comfort: a randomized controlled trial.

Aim: To compare the effects of an in-house prepared honey solution (HS) and a commercial carbohydrate beverage (CCB) on postoperative stress response, gastric motility, and self-reported comfort in patients undergoing laparoscopic cholecystectomy.

Methods: This randomized controlled trial enrolled 55 adult patients (the American Society of Anesthesiologists physical status I-II) undergoing laparoscopic cholecystectomy at the University Hospital Center Rijeka from January 1, 2022, to December 31, 2022. Participants were randomly assigned to receive either HS (n=20), prepared from diluted chestnut honey, or CCB (n=35). Both solutions were administered in the volumes of 800 mL the evening before surgery and 400 mL two hours before anesthesia. Stress response and inflammation were assessed by measuring cortisol and interleukin 6 levels at six standardized time points. Gastric motility was evaluated with a paracetamol absorption test, and patient-reported outcomes were recorded postoperatively using a visual analogue scale.

Results: The HS group exhibited higher cortisol and interleukin 6 levels at multiple perioperative time points compared with the CCB group (P<0.05). However, they had significantly improved gastric motility, with higher paracetamol concentrations 15 to 180 minutes post-ingestion (P=0.028-0.001). Additionally, HS group reported reduced thirst, nausea, and pain, but had lower appetite and well-being scores.

Conclusion: While HS represents a potential natural and cost-effective alternative to CCB, further studies are needed to determine its role within preoperative nutrition strategies for enhanced recovery after surgery.