Effects and Safety of Preoperative Oral Carbohydrate in Radical Distal Gastrectomy - A Randomized Clinical Trial

Objective: To investigate the safety of preoperative oral carbohydrate and the impact of preoperative oral carbohydrate on postoperative insulin resistance. Methods: 60 patients with gastric cancer scheduled were randomly divided into preoperative oral carbohydrate or placebo drink. Preoperative general well-being, 2-3 hours before the induction of anesthesia all patients received either a placebo drink or carbohydrate drink, blood glucose, insulin were measured before and immediately after surgery, Insulin resistance index was calculated using Homeostasis Model Assessment (HOMA), and postoperative complications and length of hospital stay were respectively recorded. Results: No complications associated with anesthesia were recorded as a result of preoperative fluid consumption. In the two groups, blood glucose, insulin and HOMA-IR immediately postoperative in the preoperative oral carbohydrate group were significantly lower than those in the preoperative oral placebo group. Insulin sensitivity index (ISI) was reduced in both groups; the oral carbohydrate group was higher than oral placebo group. There were no differences between two groups on length of hospital stay. Conclusion: Preoperative consumption of carbohydrate-containing fluid is safe. Preoperative oral carbohydrate may alleviate the postoperative immediately insulin resistance should be a routine for preoperative preparation.