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Randomized Controlled Trial
. 2025 Feb 22;20(1):191.
doi: 10.1186/s13018-025-05614-5.

Effect of preoperative oral carbohydrate on postoperative delirium in elderly patients undergoing lower extremity orthopedic surgery: a prospective randomized trial

Luo-Ting Li  1 , Xing-Hao Wang  1 , You-Bo Zuo  2   3 , Yi-Hang He  1 , Jing Lin  1 , Hong-Xia Chen  1   4 , Yue Huang  1
Affiliations
Randomized Controlled Trial

Effect of preoperative oral carbohydrate on postoperative delirium in elderly patients undergoing lower extremity orthopedic surgery: a prospective randomized trial

Luo-Ting Li et al. J Orthop Surg Res. .

Abstract

Background: Postoperative metabolic disorders and inflammatory responses are closely associated with postoperative delirium (POD). Preoperative oral carbohydrate intake can alleviate postoperative insulin resistance and the inflammatory response. This study aimed to evaluate the effects of preoperative oral carbohydrate intake on the incidence of POD in older patients undergoing lower limb orthopedic surgery.

Methods: Eighty patients were randomly assigned to oral intake of 200 mL carbohydrate solution (Group CHO) 2 h before surgery or fasting for 8 h before surgery (Group C). The primary outcome was the incidence of POD. Fasting plasma glucose, interleukin (IL)-6, and C-reactive protein (CRP) levels were assessed before surgery and 1, 3, and 5 days after surgery (D1, D3, and D5).

Results: The incidence of POD in Group CHO was lower than that in Group C (P = 0.005). Blood glucose, IL-6 and CRP levels of Group CHO were significantly lower than those of Group C on D1 and D3 (P < 0.05).

Conclusions: Preoperative oral carbohydrate intake can reduce the incidence of POD in older patients by ameliorating postoperative metabolic disorders and reducing inflammatory responses.

Trial registration: ChiCTR2300070154, Date of registration: 03/04/2023.

Keywords: Carbohydrate; Older patients; Orthopedic surgery; Postoperative delirium.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: This study was approved by the Ethics Committee of the Affiliated Hospital of North Sichuan Medical College (No. 2023ER001-1), Sichuan Province. All procedures involving human participants performed in this study were in accordance with the Ethical Standards of the Institutional Ethics Committee and the 1964 Helsinki Declaration. Informed consent was obtained from all patients or their close relatives before their participation. Consent for publication: Informed consent for the collection of research information was obtained from all participants, and the hospital review board provided informed consent for publication. Competing interests: The authors declare that they have no competing interests.

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