title: Effect of preoperative intravenous carbohydrate loading on preoperative discomfort in elective surgery patients.
abstract: OBJECTIVE
  We studied the effect of three different fasting protocols on preoperative discomfort and glucose and insulin levels.
  
  
  METHODS
  Two hundred and ten ASA I-III patients undergoing general or gastrointestinal surgery were randomly assigned to three groups: overnight intravenous 5% glucose infusion (1000 ml), carbohydrate-rich drink (400 ml) at 6-7 a.m., or overnight fasting. The subjective feelings of thirst, hunger, mouth dryness, weakness, tiredness, anxiety, headache and pain of each patient were questioned preoperatively using a visual analogue scale. Serum glucose and insulin levels were measured at predetermined time points preoperatively.
  
  
  RESULTS
  During the waiting period before surgery, the carbohydrate-rich drink group was less hungry than the fasting group (P = 0.011). No other differences were seen in visual analogue scale scores among the study groups. Trend analysis showed increasing thirst, mouth dryness and anxiety in the intravenous glucose group (P < 0.05). The carbohydrate-rich drink group experienced decreasing thirst but increasing hunger and mouth dryness (P < 0.05). In the fasting group, thirst, hunger, mouth dryness, weakness, tiredness and anxiety increased (P < 0.05). Both intravenous and oral carbohydrate caused a significant increase in glucose and insulin levels.
  
  
  CONCLUSIONS
  Intravenous glucose infusion does not decrease the sense of thirst and hunger as effectively as a carbohydrate-rich drink but does alleviate the feelings of weakness and tiredness compared with fasting.
authors.affiliation: Department of Surgery, Seinäjoki Central Hospital, Seinäjoki, Finland. heli.helminen@epshp.fi
authors.forename: Heli
authors.initials: H
authors.lastname: Helminen
authors.forename: Hanna
authors.initials: H
authors.lastname: Viitanen
authors.forename: Juha
authors.initials: J
authors.lastname: Sajanti
mesh_terms: D001786:Blood Glucose / Q000378:metabolism; D002241:Carbohydrates / Q000008:administration & dosage* / Q000494:pharmacology; D017558:Elective Surgical Procedures; D005260:Female; D006801:Humans; D007262:Infusions, Intravenous; D007328:Insulin / Q000097:blood; D008297:Male; D008875:Middle Aged; D011300:Preoperative Care; D011795:Surveys and Questionnaires
chemical_list: D001786:Blood Glucose; D002241:Carbohydrates; D007328:Insulin