Network meta‐analysis of the effect of preoperative carbohydrate loading on recovery after elective surgery. BJS 2017; 104: 187-197.
Published: 21st December 2016
Authors: M. A. Amer, M. D. Smith, G. P. Herbison, L. D. Plank, J. L. McCall
Three meta‐analyses have summarized the effects of preoperative carbohydrate administration on postoperative outcomes in adult patients undergoing elective surgery. However, these studies could not account for the different doses of carbohydrate administered and the different controls used. Multiple‐treatments meta‐analysis allows robust synthesis of all available evidence in these situations.
Article databases were searched systematically for
Some 43 trials involving 3110 participants were included. Compared with fasting, preoperative low‐dose and high‐dose carbohydrate administration decreased postoperative length of stay by 0·4 (95 per cent c.i. 0·03 to 0·7) and 0·2 (0·04 to 0·4) days respectively. There was no significant decrease in length of stay compared with water or placebo. There was no statistically significant difference in the postoperative complication rate, or in most of the secondary outcomes, between carbohydrate and control groups.
Carbohydrate loading before elective surgery conferred a small reduction in length of postoperative hospital stay compared with fasting, and no benefit in comparison with water or placebo.Full text
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