9 However, a study in a similar population and using the same preoperative regimen showed no differences between the groups on any of the measured outcomes, including nausea and vomiting.10 The product also did not reduce nausea and vomiting in patients who received the drink before coronary artery bypass surgery11 or thyroidectomy.7 Although research has demonstrated some advantages of using a preoperative oral carbohydrate, there is less information
about whether these advantages translate into improved postoperative clinical outcomes, such as shorter recovery times. Clinicians and hospital administrators are interested in whether preloading with a preoperative oral carbohydrate drink PD0332991 supplier reduces hospital length of stay; following abdominal surgery, patients usually remain in the hospital until their gastrointestinal function has been restored, so any treatment that facilitates this function may be useful in reducing length of stay. In their original 2002 paper, Kehlet and Wilmore5 suggested that the evidence base for the use of preoperative oral carbohydrates to improve
outcomes required further investigation before the buy MDV3100 researchers could recommend the intervention. Since then, there have been three trials of preoperative oral carbohydrate use that have included patients undergoing gastroenterology procedures, but their findings are contradictory.12, 13 and 14 None of these trials compared usual care with the administration of a preoperative carbohydrate drink, and one included a heterogeneous population,14 which may have masked any effects that would have been visible with a more homogeneous group. We conducted a single-site, parallel-group, randomized, controlled
trial. We used the Consolidated Standards of Reporting Trials Statement, a method for ensuring transparent reporting of trials,15 to guide trial design and reporting. All patients who were undergoing elective bowel surgery and who were 18 years of age or older were eligible for inclusion. Patients were excluded if they were non-English speaking and did Pregnenolone not have an interpreter; were pregnant; were unable to consume clear fluids; had gastrointestinal obstruction, cirrhosis, diabetes mellitus, or cognitive impairment; and were receiving corticosteroid treatment exceeding 5 mg/day. We also excluded participants who were enrolled in other trials. The hospital’s human research ethics committee approved the trial, and the trial was preregistered and assigned the Australian New Zealand Clinical Trials Registry number ACTRN12611000868987. All participants provided written consent. Our primary outcome in assessing the effectiveness of the high-carbohydrate beverage was time to readiness for discharge.