This Study Mainly Focus on the Eras Protocol Decreasing Time of Npo and Early Discharge From Hospital to Avoid Hospital Acquired Infections
Conditions
Keywords
ERAS protocol, Pre op carbohydrate loading dose, Less time of npo
Brief summary
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.
Detailed description
Preoperative fasting has traditionally been practiced to reduce the risk of aspiration during anesthesia; however, prolonged fasting may lead to increased insulin resistance, patient discomfort, and delayed postoperative recovery. Recent evidence suggests that preoperative carbohydrate loading may improve metabolic response and enhance recovery after surgery. This single-center randomized controlled trial will be conducted on 144 patients admitted for elective abdominal surgery. Eligible participants will be randomly allocated into two groups: the intervention group will receive a standardized preoperative carbohydrate drink within a defined time before surgery, while the control group will follow conventional fasting guidelines. The primary outcome of the study is postoperative recovery time, assessed using clinically relevant recovery parameters. Secondary outcomes include length of hospital stay, incidence of postoperative complications, and patient-reported comfort measures. Data will be collected prospectively during hospital stay and analyzed to determine whether preoperative carbohydrate loading provides significant benefits over standard fasting protocols. The results of this study may contribute to improving perioperative care practices and updating fasting guidelines in surgical patients.
Interventions
DIETARY_SUPPLEMENTPatients 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.
Most 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
OTHERStandard pre operative fasting
Patients 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
Sponsors
Gulab Devi Hospital
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
SUPPORTIVE_CARE
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
20 Years to 60 Years
Healthy volunteers
No
Inclusion criteria
* • Patients aged 20-60 * ASA I-II classification. * Elective open or laparoscopic abdominal surgeries.
Exclusion criteria
* • Diabetes mellitus or impaired fasting glucose. * Emergency surgeries. * Patients with hepatic or renal dysfunction. * Patients on corticosteroids or insulin-sensitizing agents. * Pregnant patients.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Post operative insuline resistance | 24 hours after surgery | 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). |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Time to first oral intake | 24 hours after surgery | 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. |
Outcome results
None listed