Effect of preoperative carbohydrate intake on gastric residual volume and pH in gynecologic laparoscopic surgery: A randomized controlled trial

Abstract

Background: Prolonged fasting before surgery is commonly practiced reducing the risk of pulmonary aspiration during anesthesia induction, but it can cause discomfort and negative recovery process. Preoperative carbohydrate intake, particularly maltodextrin solutions, has emerged as a strategy to enhance recovery while addressing these challenges. Methods: This randomized controlled trial evaluated the safety and effectiveness of preoperative maltodextrin intake in 70 patients undergoing gynecological laparoscopic surgery. Participants were divided into 2 groups: A maltodextrin group (n=35), who consumed a 15% maltodextrin solution (300 mL) 2 hours before surgery, and a fasting group (n=33), who followed conventional overnight fasting. Key outcomes included gastric residual volume (GRV) and gastric pH, assessed via ultrasound and pH measurement. Results: The mean GRV per body weight was 0.62±0.4 mL/kg in the maltodextrin group and 0.54±0.3 mL/kg in the fasting group (P=.4), showing no significant difference. Gastric pH was 3.45±1.62 in the maltodextrin group and 3.21±1.58 in the fasting group (P=.11). No cases of aspiration or reflux were observed during anesthesia. Conclusion: Preoperative maltodextrin consumption is a safe and effective alternative to traditional fasting, reducing discomfort without compromising patient safety. These findings support the integration of carbohydrate intake into enhanced recovery after surgery protocols to improve perioperative care and outcomes.