Preoperative Carbohydrate Loading in Elective Surgery A Narrative Review
DOI:
https://doi.org/10.12775/JEHS.2026.94.72957Keywords
preoperative carbohydrate loading, ERAS, perioperative nutrition, fasting, surgical outcomes, patient comfort, elective surgery, glycemic controlAbstract
Preoperative fasting has been a cornerstone of anesthetic practice for decades, yet prolonged nil-by-mouth regimens exacerbate perioperative insulin resistance, amplify the surgical stress response, and worsen patient comfort. Preoperative oral carbohydrate loading has been incorporated into Enhanced Recovery After Surgery (ERAS) protocols as a strategy to maintain a fed-like metabolic state before elective surgery, yet clinical evidence is heterogeneous, effect sizes on hard endpoints are modest, and key questions on optimal timing, dosing, and suitability in high-risk subgroups remain unresolved. This review critically appraises the effects of preoperative carbohydrate drinks on perioperative metabolic outcomes, patient-centered comfort, clinical recovery endpoints, and safety across multiple surgical specialties.
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