title: Effects of oral carbohydrate with amino acid solution on the metabolic status of patients in the preoperative period: a randomized, prospective clinical trial.
abstract: Enhanced recovery after surgery is increasingly desired nowadays, and preoperative nutrient intake may be beneficial for this purpose. In this study, we investigated whether the intake of preoperative carbohydrate with amino acid (ONS) solution can improve starvation status and lipid catabolism before the induction of anesthesia.
  
  
  
  This randomized, prospective clinical trial included 24 patients who were divided into two groups before surgery under general anesthesia: a control group, comprising patients who fasted after their last meal the day before surgery (permitted to drink only water), and an ONS group, comprising patients who consumed ONS solution 2 h before surgery. Biochemical markers, the respiratory quotient, and psychosomatic scores were assessed at the initiation of anesthesia.
  
  
  
  Compared with the control group, the ONS group showed significantly lower serum free fatty acid levels [control group: 828 (729, 1004) µEq/L, ONS group: 479 (408, 610) µEq/L, P = 0.0002, median (25th, 75th percentile)] and total ketone bodies [control group: 119 (68, 440) µmol/L, ONS group: 40 [27, 64] µmol/L, P = 0.037]. In addition, analysis using the Visual Analog Scale showed higher preoperative scores for anxiety, hunger, and thirst for the control group, with no differences in any other measure of subjective well-being between groups.
  
  
  
  The results of this study suggest that preoperative ONS intake improves lipid catabolism and starvation status before the induction of anesthesia. Furthermore, it can provide better preoperative mental health compared with complete fasting.
authors.affiliation: Department of Nutrition, Tokushima University, Tokushima, Japan.
authors.forename: Rie
authors.initials: R
authors.lastname: Tsutsumi
authors.affiliation: Department of Anesthesiology, Tokushima University, Tokushima, Japan.
authors.forename: Nami
authors.initials: N
authors.lastname: Kakuta
authors.affiliation: Department of Anesthesiology, Tokushima University, Tokushima, Japan.
authors.forename: Takako
authors.initials: T
authors.lastname: Kadota
authors.affiliation: Department of Anesthesiology, Tokushima University, Tokushima, Japan.
authors.forename: Takuro
authors.initials: T
authors.lastname: Oyama
authors.affiliation: Department of Anesthesiology, Tokushima University, Tokushima, Japan.
authors.forename: Katsuyoshi
authors.initials: K
authors.lastname: Kume
authors.affiliation: Department of Anesthesiology, Tokushima University, Tokushima, Japan.
authors.forename: Eisuke
authors.initials: E
authors.lastname: Hamaguchi
authors.affiliation: Department of Anesthesiology, Tokushima University, Tokushima, Japan.
authors.forename: Noriko
authors.initials: N
authors.lastname: Niki
authors.affiliation: Department of Anesthesiology, Tokushima University, Tokushima, Japan.
authors.forename: Katsuya
authors.initials: K
authors.lastname: Tanaka
authors.affiliation: Department of Anesthesiology, Tokushima University, Tokushima, Japan. tsutsumi@tokushima-u.ac.jp.
authors.forename: Yasuo M
authors.initials: YM
authors.lastname: Tsutsumi
mesh_terms: D000284:Administration, Oral; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000596:Amino Acids / Q000097:blood / Q000494:pharmacology*; D000768:Anesthesia, General; D001007:Anxiety / Q000523:psychology; D002241:Carbohydrates / Q000494:pharmacology*; D005260:Female; D006801:Humans; D006815:Hunger / Q000187:drug effects; D007657:Ketone Bodies / Q000378:metabolism; D050356:Lipid Metabolism / Q000187:drug effects; D008297:Male; D008660:Metabolism / Q000187:drug effects*; D008875:Middle Aged; D011300:Preoperative Care; D057234:Preoperative Period; D011446:Prospective Studies; D013894:Thirst / Q000187:drug effects; D055815:Young Adult
chemical_list: D000596:Amino Acids; D002241:Carbohydrates; D007657:Ketone Bodies
keywords: Enhanced recovery after surgery; Nutritional status; Preoperative carbohydrate; Quality of life; Surgical outcomes