Premium
Preoperative carbohydrate loading in patients undergoing coronary artery bypass or spinal surgery
Author(s) -
Tran Susan,
Wolever Thomas M.S.,
Errett Lee E.,
Ahn Henry,
Mazer C. David,
Keith Mary
Publication year - 2010
Publication title -
the faseb journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.709
H-Index - 277
eISSN - 1530-6860
pISSN - 0892-6638
DOI - 10.1096/fasebj.24.1_supplement.231.3
Subject(s) - medicine , preoperative fasting , evening , insulin , coronary artery bypass surgery , surgery , artery , insulin resistance , anesthesia , perioperative , physics , astronomy
Surgery induces a state of insulin resistance (IR) which may be aggravated by current fasting practices. Oral preoperative carbohydrate (CHO) loading may reduce postoperative IR and subsequently complications. The current study was designed to determine whether CHO loading would blunt the development of postoperative IR, reduce preoperative discomfort and improve clinical outcomes in elective coronary artery bypass or spinal surgical patients. Thirty‐eight patients were randomized to receive a CHO supplement the evening before (100g CHO) and two hours prior to surgery (50g CHO) or fast for 12 hours preoperatively. Insulin sensitivity was measured using the short insulin tolerance test and homeostasis model assessment (HOMA). Patient discomfort was measured immediately before surgery using visual analog scales. Insulin sensitivity was not significantly different between groups. However, the treated group experienced a significantly smaller rise in glucose levels following surgery (p=0.03) and had higher postoperative HOMA‐β scores (p=0.02). Supplemented patients were also significantly less thirsty (p=0.01), hungry (p=0.04) and anxious (p=0.01) before surgery and experienced a significantly shorter hospital stay (p=0.008). CHO loading improved outcomes, warranting re‐evaluation of fasting practices in this population. This research was supported by a CIHR student fellowship.