Perioperative carbohydrate loading in patients undergoing one-day surgery. A systematic review of randomized controlled trials

INTRODUCTION: It is suggested that preoperative carbohydrate loading may have beneficial effects, which is emphasised in Enhanced Recovery After Surgery protocols (ERAS). Recent data confirmed that carbohydrate loading shortens length of hospital stay. AIM: In this systematic review we aimed to determine whether carbohydrate loading have positive effects in patients undergoing 1-day surgery. MATERIAL AND METHODS: We searched 5 databases and identified some randomized controlled trials which were reviewed independently by two reviewers. In the end 6 RCTs were included, involving 411 patients. Studies compared effects of carbohydrate loading vs. fasting and/or placebo on the following outcomes: thirst, hunger, postoperative nausea and vomiting (PONV), fatigue, pain and postoperative insulin resistance. In most cases data are inconclusive as studies reported opposite results. CONCLUSIONS: It seems that carbohydrate loading did not have a significant impact when compared to fasting or placebo. Preoperative carbohydrate loading seems not to have significant benefits over fasting or placebo in patients qualified for 1-day surgery.