The effect of preoperative carbohydrate loading on patients' anxiety prior to elective caesarean delivery: a randomized controlled trial.

BACKGROUND

Preoperative oral carbohydrate loading prior to elective caesarean delivery has been proposed to enhance recovery after surgery. However, its effect on patients' preoperative anxiety remains uncertain. This study was, hence, conducted to evaluate the anxiolytic effect of oral complex carbohydrate drink in patients undergoing elective caesarean delivery. We hypothesised that patients who received preoperative oral carbohydrate loading would be less anxious before elective caesarean delivery.

METHOD: Patients undergoing elective caesarean delivery were randomized into two groups. The carbohydrate group (n=50) received 300 mL of iso-osmolar carbohydrate drink the night before surgery and two hours prior to surgery and the control group (n=50) received the same volume of regular water at the same time points. The primary outcome was preoperative anxiety, measured using the Amsterdam Preoperative Anxiety and Information Scale (APAIS). Maternal hunger, thirst and nausea, maternal and neonatal blood glucose levels, maternal urinary ketones and postoperative quality of recovery were the secondary objectives.

RESULTS

The mean ± standard devation APAIS score before surgery were lower in the carbohydrate group compared to the control group, and the difference was statistically significant (4.56 ± 1.21 vs. 6.36 ± 1.55, mean difference -1.80; 95% CI -2.35 to -1.25; P=0.005). The patients in the carbohydrate group were significantly less hungry and thirsty compared to those in the control group, and had a lower incidence of urinary ketosis and a significantly higher quality of recovery on the first postoperative day.

CONCLUSION

Oral carbohydrate loading reduces preoperative anxiety in patients scheduled for elective caesarean delivery.