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Preoperative Carbohydrate Loading in Pediatric Surgery: A Scoping Review of Current Clinical Trials

Yunita Widyastuti1, Djayanti Sari1, Anisa Fadhila Farid1

  • 1Department of Anesthesiology and Intensive Care, Faculty of Medicine, Public Health and Nursing, Dr. Sardjito General Hospital, Gadjah Mada University, Yogyakarta, Special Region of Yogyakarta, Indonesia.

F1000Research
|February 14, 2025
PubMed

Insights

Preoperative carbohydrate loading (PCL) in pediatric surgery may stabilize blood glucose and reduce metabolic risks. However, evidence on length of hospital stay and postoperative complications requires further research.

Area of Science:

  • Pediatric Surgery
  • Enhanced Recovery After Surgery (ERAS) Protocols
  • Nutritional Support

Background:

  • Preoperative carbohydrate loading (PCL) is a component of Enhanced Recovery After Surgery (ERAS) protocols.
  • It involves administering carbohydrate-rich liquids preoperatively, contrasting with traditional fasting.
  • PCL aims to improve glycemic control, mitigate insulin resistance, and enhance patient comfort.

Purpose of the Study:

  • To conduct a comprehensive scoping review of PCL in pediatric surgery.
  • To synthesize evidence on the metabolic and perioperative outcomes of PCL in pediatric patients.

Main Methods:

  • A systematic scoping review was performed using major scientific databases (PubMed, CINAHL, EMBASE, Cochrane, Scopus, Web of Science).
  • Studies published between 2017 and 2024, focusing on English-language clinical trials in pediatric populations, were included.
  • Data extraction focused on sample sizes, types of PCL interventions, and perioperative outcomes.

Main Results:

  • Eleven studies on PCL in pediatric surgery were reviewed, with participant numbers ranging from 18 to 1200.
  • Seven studies reported stabilized blood glucose levels and reduced hypoglycemia risk.
  • Five studies indicated reduced preoperative anxiety, agitation, and discomfort; five also noted improved gastric residual volume and pH.
  • Postoperative outcomes were mixed, with no significant difference in nausea/vomiting in four studies, while three showed no change in hospital stay length.

Conclusions:

  • PCL in pediatric surgery demonstrates potential for stabilizing blood glucose and improving metabolic profiles.
  • Evidence for benefits on length of hospital stay and postoperative complications is currently inconsistent.
  • Further research is warranted to clarify the impact of PCL on these critical recovery parameters.
Abstract

Keywords:
Pediatric SurgeryPerioperative CarePreoperative Carbohydrate LoadingPreoperative Fasting

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