OP043 PRE-OPERATIVE CARBOHYDRATE LOADING IMPROVES POST-OPERATIVE FOOD INTAKE

Abstract

Rationale: The “Enhanced Recovery of patients After Surgery” (ERAS) program recommends pre-operative carbohydrate loading 2 hours prior to surgery, and reestablishment of oral feeding as early as possible after surgery. The aim of this study was to investigate whether a pre-operative carbohydrate drink improves spontaneous post-operative food intake in rats. Methods: Male Wistar rats were subjected to 16h fasting with ad libitum water and: A) sham laparotomy (Sham fasted, n = 16); B) intestinal ischemia (IR fasted, n = 18); and C) intestinal ischemia with ad libitum access to a carbohydrate drink (Nutricia preOp, Nutricia N.V., Zoetermeer) (IR CHO, n = 14). The mesenteric superior artery was clamped during 70min. After surgery, animals were allowed to recover for 24h with ad libitum access to food. Spontaneous food intake was measured every hour after surgery for 24 hours. Results: In the first 24h post-operatively, rats in the IR CHO group had a significantly higher food intake (p < 0.05) compared to the rats in the IR fasted group (5.69±2.47 versus 3.82±2.01 g/24h). Moreover, rats in the IR CHO group started eating significantly earlier (p < 0.01) than the IR fasted group (4.14±1.10 versus 7.28±2.95h). Accordingly, the mean starting time of eating of the IR CHO group was equal to the time the Sham fasted group started eating. Conclusion: Pre-operative carbohydrate loading improved food intake in the first 24h post-operative. The animals started eating earlier and more during the first 24 hours than the fasted group. Moreover, after pre-operative carbohydrate loading the time point the rats started eating was normalized and equal to a sham laparotomy. There is an important role of carbohydrate loading in allowing early post operative food intake, as recommended in the ERAS guidelines. These findings suggest that pre-operative carbohydrate loading facilitates other nutritional key aspects of postoperative care.