Oral Carbohydrate Intake Impact on Cesarean Delivery Perioperative Well-Being: A Randomized Interventional Study [29Q

Abstract

INTRODUCTION: Oral carbohydrates (CHO) prior to a variety of surgical procedures has been found to attenuate the postoperative catabolic state with an improvement in well-being insulin sensitivity, cardiac output and shortened hospital stays without adverse effect. Previous work has compared oral CHO to water or flavored water and excluded pregnant women. Our primary aim was to determine if preoperative oral consumption of higher dose CHO would improve patient well-being (WB-VAS) prior to cesarean section compared to a widely available rehydration beverage with a lower CHO dose and fasted controls. METHODS: Low risk women undergoing scheduled cesarean deliveries under spinal anesthesia were recruited. Participants were randomized to either: Clearfast® (group CHO), Gatorade Thirst Quencher® (group R) or fasting control (group F). Participants in groups CHO and R received 710 mL of either beverage the night before and 355 mL two hours prior to surgery. Participants in Group F fasted after midnight the night before surgery. Two hours before surgery, baseline WB-VAS was recorded, followed by beverage consumption for groups CHO and R. One hour later, WB-VAS was repeated. Additional recorded measures included umbilical blood glucose, intraoperative variables, breastfeeding success, and quality of recovery one day after surgery. RESULTS: Group differences in change in WB-VAS were analyzed using linear regression. Both group CHO and R showed significant improvements in WB-VAS while fasted patients showed no change. There were no differences in other outcomes. CONCLUSION: Either the common oral rehydration or higher dose CHO beverage resulted in superior well-being compared to fasting with no difference in other outcomes.