Preoperative nutrition - elective surgery in the fed or the overnight fasted state

Data that have only recently become available show that preoperative administration of carbohydrate to patients undergoing elective surgery has metabolic benefits postoperatively by reducing postoperative insulin resistance. This metabolic change has been shown to be an independent factor explaining the variation in length of stay. In addition, preliminary data suggest that when the carbohydrates are given as a beverage 2-3 hours before the operation, well being is improved pre- and postoperatively. This method has been tested in a total of approximately 900 patients without any adverse events reported, suggesting that this is safe to use. Lastly, a meta-analysis of three prospective controlled trials indicates that length of stay is reduced by about 20% by preoperative carbohydrate compared with surgery in the overnight fasted state. (C) 2001 Harcourt Publishers Ltd.