Randomized clinical trial comparing an oral carbohydrate beverage with placebo before laparoscopic cholecystectomy.
BACKGROUND
Preoperative oral carbohydrate can attenuate postoperative insulin resistance and catabolism, and may have the potential to improve postoperative recovery. There are no data from randomized studies on postoperative clinical outcome after specific surgical procedures. This study evaluated the clinical effects of a preoperative carbohydrate beverage in patients undergoing laparoscopic cholecystectomy.


METHODS
Ninety-four patients undergoing laparoscopic cholecystectomy were included in a randomized clinical trial. Patients were randomized to receive 800 ml of an iso-osmolar 12.5 per cent carbohydrate-rich beverage the evening before operation (100 g carbohydrate) and another 400 ml (50 g carbohydrate) 2 h before initiation of anaesthesia, or the same volume of a placebo beverage. The primary endpoint was general well-being the day after operation. Patients were evaluated from 5 days before to 5 days after operation. Daily scores of general well-being, fatigue, appetite and pain, computerized measurements of physical activity and sleep (actigraphy), and subjective sleep quality were recorded. Nausea and vomiting were assessed twice within the first 24 h after surgery.


RESULTS
Data from 86 patients were available for statistical analysis, 43 in each treatment group. No significant intergroup differences in general well-being or any other outcome variable were found.


CONCLUSIONS
A preoperative carbohydrate beverage did not improve clinical outcome after laparoscopic cholecystectomy.
Bisgaard
T
T
Department of Surgical Gastroenterology 435, University of Copenhagen, Hvidovre Hospital, Hvidovre, Denmark. thuebisgaard@tdcadsl.dk
Kristiansen
V B
VB
Hjortsø
N C
NC
Jacobsen
L S
LS
Rosenberg
J
J
Kehlet
H
H
D000284:Administration, Oral; D000293:Adolescent; D000328:Adult; D000368:Aged; D000700:Analgesics / Q000627:therapeutic use; D000932:Antiemetics / Q000627:therapeutic use; D001628:Beverages; D002241:Carbohydrates / Q000008:administration & dosage*; D017081:Cholecystectomy, Laparoscopic / Q000379:methods*; D005221:Fatigue / Q000209:etiology; D001068:Feeding and Eating Disorders / Q000209:etiology; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D010149:Postoperative Pain / Q000209:etiology; D011183:Postoperative Complications / Q000517:prevention & control*; D011300:Preoperative Care / Q000379:methods; D011379:Prognosis; D012893:Sleep Wake Disorders / Q000209:etiology
D000700:Analgesics; D000932:Antiemetics; D002241:Carbohydrates