title: Total hip arthroplasty and perioperative oral carbohydrate treatment:  a randomised, double-blind, controlled trial.
abstract: BACKGROUND
  Perioperative oral carbohydrate intake is beneficial to general surgery patients. Total hip arthroplasty is a common surgical procedure, and even a moderate improvement in patient outcome could have a significant effect on the resources needed for these patients. However, few studies have focused on the effects of carbohydrate intake on orthopaedic patients.
  
  
  OBJECTIVE
  The purpose of this study was to investigate if perioperative oral carbohydrate intake alters the postoperative course for patients undergoing total hip arthroplasty. The primary hypothesis was that pain scores would be lower in patients treated with carbohydrate.
  
  
  METHODS
  A randomised, double-blind, controlled trial.
  
  
  METHODS
  This study was carried out between September 2009 and April 2011 at a district Swedish hospital that specialises in orthopaedic surgery.
  
  
  METHODS
  Sixty ASA physical status I-III patients scheduled for elective total hip arthroplasty were included. Exclusion criteria were obesity, diabetes, prior hip surgery to the same hip, ongoing infection, immunological deficiency or age less than 50 or more than 80 years.
  
  
  METHODS
  Patients were given 400 ml of either an oral 12.5% carbohydrate solution or a placebo beverage (flavoured water) 1.5 h before and 2 h after surgery.
  
  
  METHODS
  Visual analogue scales were used to score six discomfort parameters.
  
  
  RESULTS
  Immediately prior to surgery, the carbohydrate-treated patients were less hungry (median score 9.5 vs. 22 mm) and experienced less nausea (0 vs. 1.5 mm) (P< 0.05). Postoperatively, patients in the carbohydrate group experienced less pain at 12, 16 and 20 h (median scores 20, 30 and 34 vs. 7, 5 and 0 mm; P<0.05).
  
  
  CONCLUSIONS
  This study shows that there is limited benefit from administering oral carbohydrate prior to total hip arthroplasty.
authors.affiliation: Department of Anaesthesiology, Hässleholm Hospital and Lund University, Hässleholm, Sweden. andreas.harsten@skane.se
authors.forename: Andreas
authors.initials: A
authors.lastname: Harsten
authors.forename: Hjörtur
authors.initials: H
authors.lastname: Hjartarson
authors.forename: Sören
authors.initials: S
authors.lastname: Toksvig-Larsen
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019644:Arthroplasty, Replacement, Hip / Q000379:methods*; D002241:Carbohydrates / Q000627:therapeutic use*; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement / Q000187:drug effects; D010149:Postoperative Pain / Q000453:epidemiology / Q000517:prevention & control; D019990:Perioperative Care; D011183:Postoperative Complications / Q000453:epidemiology / Q000517:prevention & control; D011229:Preanesthetic Medication; D018401:Sample Size
chemical_list: D002241:Carbohydrates