Effects of preoperative carbohydrates drinks on immediate postoperative outcome after day care laparoscopic cholecystectomy

Abstract

Background: Postoperative nausea and vomiting is the most common cause for unexpected hospital admission of patients undergoing day care surgery. Overnight fasting changes patient metabolic state and influences their perioperative stress response. Preoperative carbohydrate loading may have accelerated recovery and better overall outcome after major abdominal surgery. The aim of the study was to investigate the effects of preoperative carbohydrate-rich drinks on postoperative nausea and vomiting and pain after day care laparoscopic cholecystectomy.

Methods: A total of 120 patients posted for day care laparoscopic cholecystectomy were included in the study and were randomized into three groups. Group A (Cases)-receiving the carbohydrate-rich drink before surgery (CHO), group B (placebo)-receiving the placebo drink before surgery and group C (controls)-fasting from midnight before surgery. Postoperative nausea and vomiting and visual analogue score for pain were noted and analyzed for 24 h.

Results: Mean score of nausea in 0-4 h in group A was significantly lower as compared to group B and group C (p = 0.001). Difference in mean score of nausea in 4-12 and 12-24 h between groups was not significant (p = 0.066), (p = 0.257). Mean score of vomiting in 0-4 and 4-12 h in group A was significantly less than that of group B and group C (p = 0.004), (p = 0.001). Mean score of pain in group A was significantly less when compared to group B and group C in 0-4 h (p = 0.001) and 4-12 h (0.005).

Conclusion: Perioperative consumption of a carbohydrate-rich drink can minimize postoperative nausea, vomiting and pain in patients undergoing outpatient cholecystectomy. Consumption of carbohydrate drinks up to 2 h prior to surgery is not associated with additional complications.

Keywords: Carbohydrate-rich drinks; Day care laparoscopic cholecystectomy; Postoperative nausea and vomiting.