This randomized controlled trial aims to compare the effect of preoperative carbohydrate loading versus standard overnight fasting on postoperative recovery time in patients undergoing elective abdominal surgery. A total of 144 admitted patients will be randomly assigned to either receive a preoperative carbohydrate drink or follow routine fasting protocols. The primary objective is to evaluate differences in postoperative recovery time between the two groups. Secondary outcomes include length of hospital stay, postoperative complications, and patient comfort. The findings of this study may help optimize preoperative fasting guidelines and improve patient recovery outcomes.
• Patients aged 20-60
ASA I-II classification.
Elective open or laparoscopic abdominal surgeries.
• Diabetes mellitus or impaired fasting glucose.
Emergency surgeries.
Patients with hepatic or renal dysfunction.
Patients on corticosteroids or insulin-sensitizing agents.
Parallel
Patients will be given 400 mL of a carbohydrate-rich clear drink (10% daxtrosewater) approximately 2-3 hours before induction of anesthesia, according to ERAS guidelines.
Dietary supplementMost previous studies have evaluated preoperative carbohydrate loading in mixed surgical populations or in settings outside Pakistan. Limited local data exist specifically for elective abdominal surgery patients in a single-center Pakistani tertiary care hospital setting. Thisstudy focuses on comparing a standardized carbohydrate loading dose with conventional fasting and assessing its direct impact on postoperative recovery time in your local population. surgery patients specifically It uses a standardized carbohydrate loading dose It compares against the routinely practiced prolonged fasting protocol It is conducted in a single-center local hospital population, where local evidence is limited It focuses on postoperative recovery time as the primary clinical outcome
Standard pre operative fasting
Other interventionPatients in this group will follow the routine preoperative fasting protocol according to hospital and anesthesia guidelines, including overnight fasting from solids and clear liquids before elective abdominal surgery. No preoperative carbohydrate loading will be give
Post operative insuline resistance
To evaluate the effect of preoperative oral carbohydrate loading compared with standard fasting on postoperative insulin resistance in patients undergoing elective abdominal surgery. Insulin resistance will be assessed by measuring fasting blood glucose and serum insulin levels preoperatively and postoperatively, and calculating insulin resistance using the Homeostatic Model Assessment for Insulin Resistance (HOMA-IR).
Time to first oral intake
To compare the duration from completion of surgery until the patient tolerates first oral intake (clear fluids or oral diet) between the preoperative carbohydrate loading group and the standard fasting group. This outcome reflects early postoperative gastrointestinal recovery and readiness for oral feeding.
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