The Effect of Preoperative Oral Carbohydrate Administration on Postoperative Glucometabolic Response, Subjective Well-being and Quality of Life in Patients Undergoing Colorectal Surgery: A Randomized Prospective Trial
Phase: NA
Conditions: Colorectal Cancer, Glucometabolic Response, Subjective Goodness, Life Quality
Sponsor: Muğla Sıtkı Koçman University

The Effect of Preoperative Oral Carbohydrate Administration on Postoperative 
Glucometabolic Response, Subjective Well Being and Quality of Life in Patients 
Undergoing Colorectal Surgery: A Randomized Controlled Double-Blind Study 
 
Trial registration: NCT05402592 
Date of the document: 06.03.2025 
 
Murat URKAN1, Cemile CELEBI2, Ulvi Mehmet MERAL3, Ikbal CAVDAR4 
1 Associate Professor Doctor, Department of General Surgery, Acibadem Bodrum Hospital, 
Muğla, Turkey, murat.urkan@acibadem.com/ muraturkan@gmail.com ORCID: 0000-0002-
3191-4724 
2 Assistant Professor Doctor, PhD, Muğla Sıtkı Koçman University Faculty of Health 
Sciences, Department of Nursing, Department of Surgical Diseases Nursing, Muğla/Turkey, 
cemilecelebi@mu.edu.tr /ccelebi48@gmail.com ORCID:0000-0001-9960-7205 
3 Doctor, Kayseri State Hospital, Department of General Surgery, Kayseri, Turkey, 
ulvimeral@yahoo.com  ORCID: 0000-0001-7399-6353 
4 Professor Doctor, Istanbul Atlas University, Faculty of Health Sciences, Department of 
Nursing, Istanbul, Turkey, ikbal.cavdar@atlas.edu.tr ORCID: 0000-0002-8242-6165 
• Corresponding 
author: 
Cemile 
ÇELEBİ/ 
cemilecelebi@mu.edu.tr 
/ccelebi48@gmail.com  
 
 
 
 
 
 
 
 
 
 

INTRODUCTION  
Preoperative fasting has traditionally been a standard practice for patients undergoing elective 
surgery, primarily aimed at reducing the risk of pulmonary aspiration (1). However, prolonged 
fasting periods have been associated with increased preoperative anxiety, delayed surgical 
recovery, and heightened perioperative insulin resistance (PIR) (2,3). Surgical trauma, 
combined with prolonged fasting, exacerbates catabolic processes and triggers a metabolic 
stress response, leading to increased patient discomfort and complications (4,5). In response 
to these challenges, recent research and evidence-based guidelines have shifted focus toward 
minimizing the duration of preoperative fasting. Notably, the administration of oral 
carbohydrates in the preoperative period has been recommended to mitigate these adverse 
effects (6,7). 
The Enhanced Recovery After Surgery (ERAS) protocols advocate for preoperative oral 
carbohydrate loading, particularly in patients undergoing elective colorectal surgery (6). 
Preoperative carbohydrate intake has been shown to modulate perioperative metabolism, 
reduce the stress response to surgical trauma, prevent complications, improve surgical 
outcomes, shorten hospital stays, and decrease postoperative morbidity and mortality (8–11). 
The International Society of Anaesthesia has confirmed the safety of oral carbohydrate intake, 
stating that it does not increase the risk of anesthesia-related complications. Furthermore, 
reducing the fasting period and administering carbohydrate-containing liquids have been 
shown to alleviate perioperative thirst, hunger, weakness, fatigue, anxiety, postoperative 
nausea and vomiting, and to promote intestinal peristalsis and shorter hospital stays (12–15). 
Despite these advancements, there remains a gap in the literature regarding the comprehensive 
impact of preoperative carbohydrate loading on postoperative quality of life and subjective 
well-being, particularly in the context of colorectal surgery. While previous studies have 
primarily focused on metabolic outcomes and clinical recovery parameters, the effects on 

patient-reported outcomes such as quality of life and subjective well-being have not been 
thoroughly investigated. This study aims to address this gap by examining the effects of 
preoperative oral carbohydrate ingestion on postoperative glucometabolic response, subjective 
well-being, quality of life, and surgical clinical outcomes in patients undergoing colorectal 
surgery. 
The originality of this study lies in its holistic approach to evaluating both clinical and patient-
centered outcomes. By integrating traditional clinical metrics with patient-reported outcomes, 
this research provides a more comprehensive understanding of the benefits of preoperative 
carbohydrate loading. Furthermore, the study employs a double-blind, randomized controlled 
design, ensuring robust and unbiased results. The findings of this study have the potential to 
inform clinical practice by highlighting the multifaceted benefits of preoperative carbohydrate 
administration, thereby contributing to the optimization of perioperative care protocols. 
Research Hypotheses 
H1-1: Preoperative oral carbohydrate intake reduces postoperative insulin resistance in 
patients undergoing colorectal surgery. 
H1-2: Preoperative oral carbohydrate intake improves subjective well-being in patients 
undergoing colorectal surgery. 
H1-3: Preoperative oral carbohydrate intake enhances the quality of life in patients 
undergoing colorectal surgery. 
METHODS 
Participants and sampling 
This prospective, randomized controlled double-blind study was conducted at the General 
Surgery Clinic of A University Hospital between January 2022 and April 2023. The sample 
size was determined based on an effect size calculation derived from a previous study by 
Yagci et al. (3), which reported a mean glucose level difference of 12.18 mg/dL between the 

experimental and control groups. Using this data, the effect size (d) was calculated as 0.72. 
With a 95% confidence level (1-α) and 80% statistical power (1-β), the G*Power software 
(version 3.1) was used to determine that a minimum of 25 participants per group (50 
participants in total) would be required to detect significant differences between the groups. 
The study population consisted of patients aged 18 years or older who were scheduled for 
elective colorectal surgery and had the capacity to provide informed consent. Participants 
were classified as American Society of Anesthesiologists (ASA) physical status I, II, or III. 
Exclusion criteria included patients diagnosed with diabetes, gastroesophageal reflux disease 
(GERD), severe liver or kidney failure, hiatal hernia, or those with oral nutrition difficulties. 
Additionally, emergency cases and patients classified as ASA IV or higher were excluded 
from the study. 
Randomization and blinding 
Randomization was performed by a researcher who were not directly involved in the clinical 
aspects 
of 
the 
study, 
with 
a 
sequence 
generated 
by 
a 
computer 
program 
(https://www.random.org) to assign 50 patients randomly to 2 groups in an unbiased manner. 
The list was kept secret from the patients and the researchers who registered and evaluated the 
patients until the final of the study. To maintain blinding, the study beverages were prepared 
in bottles of the same form by a nutrition company employee who was not actively engaged in 
the research process. Additionaly, the  statistical analysis was performed independently by an 
experienced statistician, who was not directly involved in the study. 
Data collection 
The data were compiled via a personal interview with the participants, who were asked to 
complete a four-part evaluation form. This form was designed by the research team and based 
on the findings of relevant literature. 

 
Observation indicators 
Primary outcomes: Reducing insulin resistance (below 2.5 mg/dl), shortening hospital stay, 
ensuring subjective well-being. 
Secondary outcomes: The early return of bowel movements, shorter passing-gas time, and 
higher quality of life on the 30th day after surgery were observed in patients who received 
carbohydrate-rich drinks. 
Interventions 
The study interventions were designed to evaluate the effects of preoperative carbohydrate 
intake on postoperative outcomes. Participants were divided into two groups: the intervention 
group (carbohydrate drink) and the control group (water). Both groups followed a 
standardized protocol, as outlined below: 
Intervention Group: Patients in the intervention group were administered 800 mL of a 
carbohydrate-rich drink (12.5 g carbohydrate per 100 mL, containing 12% monosaccharides, 
12% disaccharides, and 76% polysaccharides, with an osmolality of 285 mOsm/kg) until 
midnight on the day before surgery. Additionally, 400 mL of the same carbohydrate drink was 
given 2-3 hours before the surgical procedure (Figure 1). 
Control Group: Patients in the control group received 800 mL of water until midnight on the 
day before surgery and 400 mL of water 2-3 hours before the procedure (Figure 1). 
Data Collection: 
Data were collected in four main categories: 
Descriptive Characteristics: Age, gender, education level, marital status, occupation, body 
mass index (BMI), smoking and alcohol use, presence of chronic diseases, ASA score, and 
clinical outcomes (time to first flatulence, first defecation, first oral feeding, first 
mobilization, and hospital stay). 

Laboratory Findings: Gastric pH, gastric volume, and blood markers (glucose, insulin, 
cortisol, albumin, potassium, sodium, magnesium, and urea) were measured at specific time 
points (preoperatively and 24 hours postoperatively). 
Subjective Well-Being: Postoperative comfort indicators (pain, thirst, hunger, dry mouth, 
nausea, vomiting, weakness, and anxiety) were assessed using a Visual Analog Scale (VAS). 
The VAS is a 10 cm horizontal or vertical line, with endpoints labeled "No Pain" (0) and 
"Unbearable Pain" (10). Patients mark their level of discomfort on the line, and the score is 
measured in centimeters. A score of 0 indicates no discomfort, 1-4 indicates mild discomfort, 
5-6 indicates moderate discomfort, and 7-10 indicates severe discomfort (16). The VAS was 
administered at specific postoperative time points (e.g., 8, 12, and 24 hours) to evaluate 
changes in subjective well-being. 
Quality of Life: The SF-36 Quality of Life Scale was used to evaluate eight health domains 
30 days after surgery. The SF-36 is a self-reported questionnaire consisting of 36 items that 
assess physical functionality, social functionality, role limitations due to physical and 
emotional problems, mental health, vitality, pain, and general health perception. Each domain 
is scored from 0 to 100, with higher scores indicating better health-related quality of life (17). 
The SF-36 was administered 30 days postoperatively to assess the long-term impact of 
preoperative carbohydrate intake on patients' quality of life. 
Application of the Intervention 
• Patients were informed about the study during their preoperative assessment and 
provided both verbal and written consent. 
• Participants were instructed to maintain regular eating and sleeping patterns for three 
days prior to hospitalization. 
• Blood samples were collected at four time points: before the morning dose, 40 minutes 
and 90 minutes after drink ingestion, and during anesthesia induction. 

• Gastric residue was measured intraoperatively using a nasogastric or orogastric tube, 
and pH values were recorded using a urine pH meter. 
Statistical analysis 
The statistical analysis was conducted via the IBM SPSS Statistics 26 software (IBM Corp., 
Armonk, NY, USA). The distribution of scores obtained from each continuous variable was 
investigated using a combination of descriptive, graphical and statistical methods. The 
Shapiro-Wilk test was employed to ascertain the normality of the scores obtained from a 
continuous variable utilising a statistical methodology. Categorical variable data are presented 
as frequencies (n, %), while continuous variable data are presented as means±standard 
deviations. In order to make comparisons between two groups in relation to normally 
distributed quantitative variables, an independent sample t-test was employed. Conversely, 
when the variables in question were not normally distributed, a Mann-Whitney U test was 
used. To compare qualitative data between groups, chi-square tests (including the Yates 
correction and Fisher's exact test) were employed. The results were evaluated for statistical 
significance within the 95% confidence interval, with p<0.05 deemed significant. 
RESULTS 
Patient descriptive characteristics 
The mean age of the patients included in the study was 66.64±10.26 years, 52% were male, 
the average BMI level was 25.44±3.37, 84% were married, and 74% were primary education. 
It was determined that 30% of the participants smoked, 20% consumed alcohol and 72% had 
a chronic disease. No statistically significant differences were observed in the distribution of 
the descriptive characteristics of the patients according to the research groups (Table 1). 
Postoperative features 
In the preoperative period, a comparison was made among the patients in the experimental 
group and those in the control group in the postoperative period; gas, stool passage, transition 

to oral feeding, mobility, and length of stay were statistically significantly shorter (p<0.001) 
(Table 2). 
Laboratory findings 
The plasma glucose level in the patients in the experimental group was found to be 
statistically significantly lower in the preoperative period (p=0.002). However, plasma 
glucose (p<0.001) and insulin (p = 0.029) levels were determined to be higher in the 
measurement made during anaesthesia induction. Preoperative CRP (p=0.013) and both 
preoperative and postoperative 24th hour urea (p=0.034 and p=0.040) levels were 
significantly lower in the patients in the experimental group; It was determined that 
preoperative magnesium (p=0.025), postoperative 24th hour potassium (p=0.035) and both 
preoperative and postoperative 24th hour albumin (p=0.003 and p<0.001) levels were 
significantly higher (Table 2). 
Life quality 
When the SF-36 quality of life scale scores of the patients were examined, except for the 
vitality and emotional role difficulty sub-dimensions (p>0.05), all other sub-dimensions were 
different between the research groups (p<0.01 and p<0.001). It was demonstrated that the 
quality of life, as measured by physical functionality, physical role difficulties, general health, 
pain, social function and mental health, was significantly superior in the patients in the 
experimental group. (Table 2). 
Patients' subjective well-being-related characteristics 
Thirst at the 8th postoperative hour (p=0.018); The level of hunger (p=0.005) at the 12th hour 
and pain (p=0.007) at the 24th hour in the patients in the experimental group; It was 
established that the level of fatigue at the 12th and 24th postoperative hours (p<0.001) was 
significantly better only in the in the control group patients (Table 3). 
 

Ethics approval and consent to participate 
The single-center, randomized controlled double-blind study was registered in the 
ClinicalTrials database (https://clinicaltrials.gov, NCT05402592). Prior to the commencement 
of the research, approval was sought and obtained from the Mugla Sitki Kocman University 
Clinical Research Ethics Committee (22.12.2021-27/II) and the chief physician of the hospital 
where the research would be conducted. In conducting the research, the authors adhered to the 
principles set forth in the Declaration of Helsinki. Written and verbal informed consent was 
obtained from all patients participating in the study. It was explained to the patients that all 
data would be confidential and that they had the right to withdraw from the study at any time. 
This research was conducted in accordance with Consolidated Standards of Reporting Trials 
(CONSORT) 2010 guidelines. 
Table 1: Patient descriptive characteristics 
Characteristics 
Total 
(n=50) 
Experiment 
(n=25) 
Control 
(n=25) 
Test value 
P-value 
Age, mean±SD 
66.64±10.26 
67.04±7.63 
66.24±12.51 
0.273a 
0.786 
BMI, mean±SD 
25.44±3.37 
25.86±3.81 
25.02±2.89 
0.886a 
0.380 
Gender, n (%) 
 
 
 
0.721b 
0.396 
Female 
24(48.0) 
14(56.0) 
10(40.0) 
 
 
Male 
26(52.0) 
11(44.0) 
15(60.0) 
 
 
Marital status, n (%) 
 
 
 
-c 
0.999 
Married 
42(84.0) 
21(84.0) 
21(84.0) 
 
 
Single 
8(16.0) 
4(16.0) 
4(16.0) 
 
 
Education, n (%) 
 
 
 
0.884c 
0.804 
Primary education  
37(74.0) 
18(72.0) 
19(76.0) 
 
 
High school 
6(12.0) 
4(16.0) 
2(8.0) 
 
 
University 
7(14.0) 
3(12.0) 
4(16.0) 
 
 
Smoking, n (%) 
 
 
 
0.000b 
0.999 
Yes 
15(30.0) 
7(28.0) 
8(32.0) 
 
 
No 
35(70.0) 
18(72.0) 
17(68.0) 
 
 
Alcohol, n (%) 
 
 
 
-c 
0.289 
Yes 
10(20.0) 
7(28.0) 
3(12.0) 
 
 
No 
40(80.0) 
18(72.0) 
22(88.0) 
 
 
Chronic disease, n (%) 
 
 
 
2.480b 
0.115 
Yes 
36(72.0) 
15(60.0) 
21(84.0) 
 
 

No 
14(28.0) 
10(40.0) 
4(16.0) 
 
 
p>0.05, a: Independent samples t test, b: Chi-square test with Yates correction, c: Fisher's exact testi, 
SD:Standard deviation 
 
 
Table 2: Some laboratory, quality of life and other postoperative findings of the patients 
 
Total (n=50) 
Experiment 
(n=25) 
Control 
(n=25) 
 
 
Variables 
Mean±SD 
Mean±SD 
Mean±SD 
Test value 
P-value 
Gas output 
43.30±5.12 
40.60±4.52 
46.00±4.22 
-4.010a 
<0.001* 
Stool output 
75.24±10.71 
68.64±7.94 
81.84±8.97 
-4.721a 
<0.001* 
Oral nutrition 
46.12±4.93 
43.80±4.84 
48.44±3.87 
-3.675a 
<0.001* 
Mobilisation 
12.58±1.64 
12.16±1.77 
13.00±1.41 
1.853b 
0.070 
Duration of postoperative 
hospitalisation 
12.48±3.36 
10.64±1.52 
14.32±3.69 
-4.494a 
<0.001* 
HOMA-IR score 
1.83±0.52 
1.70±0.41 
1.97±0.59 
-1.951a 
0.051 
Gastric pH 
4.76±5.72 
5.59±8.04 
3.94±0.92 
-0.223a 
0.823 
Gastric volume 
0.37±0.06 
0.37±0.05 
0.37±0.07 
0.211b 
0.834 
Plasma-glucose 
 
 
 
 
 
Preoperative 
87.50±16.30 
80.24±7.66 
94.75±19.35 
-3.150a 
0.002* 
40.min 
95.86±17.70 
91.04±10.67 
100.67±21.84 
-1.400a 
0.162 
90.min 
103.04±20.83 
105.04±21.02 
101.04±20.87 
-1.399a 
0.162 
Anaesthesia induction 
115.63±22.26 
123.80±18.96 
107.47±22.66 
-3.611a 
<0.001* 
Plasma-insulin 
 
 
 
 
 
Preoperative 
8.54±1.69 
8.68±2.10 
8.40±1.19 
-0.160a 
0.873 
40.min 
9.18±2.40 
9.98±2.91 
8.37±1.40 
-1.792a 
0.073 
90.min 
10.64±4.79 
12.13±6.33 
9.16±1.47 
-1.679a 
0.093 
Anaesthesia induction 
10.72±3.27 
11.91±4.16 
9.68±1.71 
-2.184a 
0.029* 
Plasma-cortisol 
 
 
 
 
 
Preoperative 
12.35±1.77 
12.08±2.17 
12.60±1.29 
1.024b 
0.311 
40.min 
14.27±4.95 
15.25±6.85 
13.32±1.46 
-0.071a 
0.943 
90.min 
14.94±4.91 
15.67±6.78 
14.24±1.79 
-0.789a 
0.430 
Anaesthesia induction 
15.13±2.56 
15.32±3.51 
14.96±1.23 
-1.008a 
0.313 
CRP 
 
 
 
 
 

Preoperative 
29.76±72.18 
4.61±11.61 
54.91±95.83 
-2.484a 
0.013* 
Postoperative 24th hour 
95.96±81.83 
73.33±48.74 
118.58±101.14 
-1.106a 
0.269 
Albumin 
 
 
 
 
 
Preoperative 
40.61±7.16 
43.64±3.28 
37.57±8.64 
-2.935a 
0.003* 
Postoperative 24th hour 
36.89±7.54 
40.72±4.13 
33.07±8.28 
4.135b 
<0.001* 
Potassium 
 
 
 
 
 
Preoperative 
4.30±0.48 
4.32±0.47 
4.29±0.49 
0.262b 
0.795 
Postoperative 24th hour 
4.19±0.46 
4.35±0.36 
4.04±0.51 
-2.110a 
0.035* 
Sodium 
 
 
 
 
 
Preoperative 
139.73±2.49 
139.80±2.33 
139.65±2.68 
0.211b 
0.834 
Postoperative 24th hour 
140.34±2.26 
140.20±1.44 
140.48±2.89 
0.434b 
0.667 
Magnesium 
 
 
 
 
 
Preoperative 
2.26±0.54 
2.47±0.62 
2.05±0.36 
-2.244a 
0.025* 
Postoperative 24th hour 
2.20±0.53 
2.34±0.58 
2.05±0.44 
-1.569a 
0.117 
Urea 
 
 
 
 
 
Preoperative 
26.33±12.17 
23.01±5.65 
29.65±15.74 
-2.125a 
0.034* 
Postoperative 24th hour 
26.74±25.68 
20.84±4.72 
32.64±35.38 
-2.057a 
0.040* 
SF-36 
 
 
 
 
 
Physical functioning 
71.70±17.46 
82.00±11.81 
61.40±16.17 
-4.357a 
<0.001* 
Role limitations due to 
physical health 
50.00±33.12 
63.00±30.72 
37.00±30.72 
-2.770a 
0.006* 
Pain 
67.75±13.18 
73.20±13.95 
62.30±9.92 
-3.467a 
0.001* 
General health 
61.40±14.81 
68.80±15.09 
54.00±10.31 
-4.171a 
<0.001* 
Vitality 
69.40±12.23 
72.20±13.77 
66.60±9.97 
-1.637a 
0.102 
Social functioning 
60.25±21.23 
71.00±22.16 
49.50±13.73 
-3.791a 
<0.001* 
Role limitations due to 
emotional health 
80.00±29.35 
81.33±27.35 
78.67±31.74 
-0.133a 
0.894 
Mental health  
78.48±10.28 
83.36±7.36 
73.60±10.58 
-3.336a 
0.001* 
*p<0.05, a=Mann-Whitney U Test, b=Independent Samples Test, SD=Standard deviation 
 
 
 
 
 

Table 3: Subjective well-being-related characteristics of patients 
 
 
At 06.00 a.m.  
Preop 
Postop 8th 
hour 
Postop 12th 
hour 
Postop 24th 
hour 
Variables 
Grup 
Mean±SD 
Mean±SD 
Mean±SD 
Mean±SD 
Mean±SD 
Pain 
Experiment 
0.16±0.55 
0.12±0.44 
1.80±1.41 
3.24±0.72 
3.12±0.97 
 
Control 
0.00±0.00 
0.00±0.00 
1.44±1.42 
3.24±0.97 
3.88±0.93 
 
Test valuea 
-1.429 
-1.429 
-0.915 
-0.023 
-2.675 
 
P-value 
0.153 
0.153 
0.360 
0.982 
0.007* 
Dehydration Experiment 
0.24±0.66 
0.12±0.44 
1.00±1.91 
2.92±1.50 
4.76±1.05 
 
Control 
0.00±0.00 
0.16±0.37 
1.52±1.23 
2.80±1.12 
4.32±1.52 
Test valuea 
-2.063 
-0.792 
-2.360 
-0.627 
-0.529 
 
P-value 
0.039* 
0.428 
0.018* 
0.531 
0.597 
Hunger 
Experiment 
0.24±1.20 
0.28±1.21 
0.48±1.64 
1.36±1.66 
4.00±1.55 
 
Control 
0.08±0.40 
0.52±0.71 
0.88±1.42 
2.52±1.76 
4.08±1.38 
Test valuea 
-0.029 
-2.509 
-1.830 
-2.802 
-0.409 
 
P-value 
0.977 
0.012* 
0.067 
0.005* 
0.683 
Dry Mouth 
Experiment 
0.20±0.50 
0.16±0.62 
1.92±1.50 
3.44±1.19 
5.08±1.08 
Control 
0.00±0.00 
0.12±0.33 
2.24±1.09 
3.60±1.04 
4.88±1.67 
 
Test valuea 
-2.063 
-0.410 
-1.779 
-1.322 
-0.454 
 
P-value 
0.039* 
0.682 
0.075 
0.186 
0.650 
Nausea 
Experiment 
0.04±0.20 
0.08±0.28 
0.68±0.80 
1.44±0.96 
1.96±1.27 
 
Control 
0.04±0.20 
0.56±0.92 
1.08±1.08 
1.88±1.17 
2.16±1.37 
 
Test valuea 
0.000 
-2.225 
-1.276 
-1.552 
-0.627 
 
P-value 
1.000 
0.026* 
0.202 
0.121 
0.531 
Fatigue 
Experiment 
0.00±0.00 
0.00±0.00 
1.56±1.19 
2.76±0.97 
3.84±1.25 
 
Control 
0.00±0.00 
0.00±0.00 
1.12±1.09 
1.32±1.31 
1.72±1.54 
 
Test valuea 
0.000 
0.000 
-1.298 
-3.805 
-4.699 
 
P-value 
1.000 
1.000 
0.194 
<0.001* 
<0.001* 
Anxiety 
Experiment 
2.36±2.12 
3.64±2.18 
2.68±1.49 
2.76±1.59 
3.32±1.55 
 
Control 
1.28±2.64 
1.52±2.57 
1.44±1.78 
1.08±1.32 
1.04±1.59 
Test valuea 
-2.425 
-3.153 
-2.560 
-3.569 
-4.278 
 
P-value 
0.015* 
0.002* 
0.010* 
<0.001* 
<0.001* 
*p<0.05, a=Mann-Whitney U Test, SD=Standard deviation 
 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Assessed for eligibility (n=57) 
Excluded (n=7) 
Diagnosed with diabetes (n=5) 
ASA score IV and above (n=2) 
Intervention  Group 
Control Group 
Allocated to intervention (n=25) 
- Patients were given 800 mL of carbohydrate 
drinks until 24.00 at night before the surgery and 
400 mL of carbohydrate drinks (Nutricia 
Fantomalt) 2-3 hours before the surgery.  
- Did not receieved allocated intervention (n=0) 
Allocated to control (n=25) 
- Patients in the control group were given 800 
mL of water until 24.00 at night before the 
surgery, and 400 mL of water 2-3 hours before 
the surgery. 
- Did not receieved allocated intervention 
(n=0) 
Lost to follow-up (n=0) 
Discounted intervention (n=0) 
 
Follow-Up 
Analysis 
Analysed (n=25) 
Excluded from analysis (n=0) 
Analysed (n=25) 
Excluded from analysis (n=0) 
Allocation 
Enrollment 
Lost to follow-up (n=0) 
Discounted intervention (n=0) 
 
Randomized (n=50) 
Figure 1: CONSORT Flow Diagram 

 
 
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