Observational study of the effect of preoperative consumption of different doses of carbohydrates before spinal surgery

Abstract

Abstract Objective To investigate the effects of two carbohydrate doses administered 2 hours prior to spinal surgery on the perioperative period of patients, aiming to add evidence to help optimize enhanced recovery after surgery (ERAS). Methods One hundred patients undergoing spinal surgery were divided into a 200 ml carbohydrate group (group A) and a 400 ml carbohydrate group (group B), with 50 patients in each group, according to the random number method. Patients in both groups consumed the carbohydrates (maltodextrin fructose drink) 2 hours before surgery. The gastric antral cross-sectional area (CSA) of the patients was recorded using gastric ultrasound at different time points. Gastric volume (GV), gastric emptying rate, and the proportion of patients with gastric emptying were calculated. Postoperative hunger, thirst, and anxiety scores were recorded on a visual analog scale (VAS). Postoperative nausea and vomiting (PONV) and length of stay (LOS) were recorded. Results The mean CSA and GV of both groups had returned to baseline at T4, with no significant difference from Tm (P > 0.05). Group B exhibited a lower gastric emptying rate than group A during period A1 (P < 0.05), while it was faster in group B during periods A2, A3, and A4 (P < 0.05). At T4, almost all patients had gastric emptying, the emptying rates of group A and group B being 92% and 88%, respectively. When comparing the blood glucose values before drinking (Tm) vs. after the operation (T5), there were no differences in either group (P > 0.05). The hunger and thirst scores of patients in group B were significantly lower than those in group A (P < 0.05). There was no significant difference in anxiety score, incidence of nausea and vomiting or length of stay (P > 0.05). Conclusion Oral carbohydrate drinks of 400 ml or 200 ml administered 2 hours prior to spinal surgery are safe for patients and can be incorporated into ERAS protocols to minimize postoperative complications and facilitate patient recovery. The larger 400 ml carbohydrate dose brings no increased risk of aspiration and effectively alleviates patient discomfort such as hunger and thirst.