The effect of preoperative oral carbohydrate intake on perioperative well-being in patients undergoing hip and lower extremity orthopedic surgery under spinal anesthesia: a randomized controlled trial.

BACKGROUND

The administration of preoperative oral carbohydrate (POC) has been shown to enhance patient well-being and expedite postoperative recovery. Nevertheless, evidence regarding its efficacy in orthopedic patients remains insufficient and warrants further investigation. This study aimed to address gaps by evaluating the effect of preoperative oral dextrose (POD) intake on perioperative well-being parameters (including thirst, hunger, anxiety, pain, nausea, and vomiting) in patients undergoing hip and lower extremity surgeries with spinal anesthesia.

METHODS

In this randomized controlled trial, 70 adult patients scheduled for orthopedic surgery were assigned to either the dextrose (POD intake) group or the fasting group (routine fasting periods of 8-10 h). Perioperative subjective well-being, including measures of thirst, hunger, anxiety, pain, nausea, and vomiting, was evaluated using the Visual Analogue Scale (VAS) both preoperatively and at multiple postoperative time points (T0, T6h, and T24h). Adverse postoperative events were monitored for 24 h following surgery.

RESULTS

Significant improvements in perioperative thirst and pain scores were observed in the dextrose group compared to the fasting group (p = 0.041 and p = 0.003, respectively). The dextrose group consistently reported lower VAS scores for thirst, hunger, pain, and anxiety across all time points (T0, T6h, T24h) (p < 0.001). No significant differences were found between groups for nausea or vomiting (p > 0.05).

CONCLUSION

The administration of preoperative oral carbohydrate (POC) showed no clinically significant impact on perioperative nausea or vomiting in orthopedic patients. However, it significantly improved other perioperative well-being parameters such as thirst, hunger, anxiety, and pain, highlighting its potential to enhance patient comfort and recovery outcomes.

TRIAL REGISTRATION: Iranian Registry of Clinical Trials, IRCT20191017045139N2. Registered on 28 January 2024.