The Effects of Preoperative Oral Dextrose Loading on Mobility Independence and Perioperative Comfort in Patients...

Orthopedic surgery induces trauma and metabolic disturbance, delaying recovery. Preoperative oral carbohydrate loading (POCL), integral to Enhanced Recovery After Surgery protocols, may alleviate these effects. This study aimed to assess the effects of preoperative oral dextrose loading (PODL/POCL) on mobility independence, perioperative comfort, and hospitalization outcomes (intensive care unit [ICU] and total length of stay) in patients undergoing orthopedic surgery.

The design was a single-blind randomized controlled trial.

In this randomized controlled trial, 70 patients scheduled for elective hip or lower extremity surgery were randomized into two groups: a fasting group (8 to 10 hours) and a dextrose group (200 mL of oral dextrose administered 2 to 3 hours preoperatively). Patient comfort, including dry mouth, sleep quality, fatigue, and weakness, was assessed at three timepoints: T0 (30 minutes preoperatively, before spinal anesthesia), T6h (6 hours postoperatively), and T24h (24 hours postoperatively), using the Visual Analog Scale. Early mobility independence was evaluated using the Cumulative Ambulatory Score. Additionally, durations of hospital and ICU stay were recorded.

PODL improved oral dryness and sleep quality compared with the fasting group (F = 44.16, effect size [ES] = 0.39, P < .001; F = 4.42, ES = 0.061, P = .02, respectively). Moreover, between-group analysis showed significant reductions in both pre- and postoperative oral dryness, as well as postoperative sleep quality (P < .05). Pre- and postoperative fatigue was significantly greater in the dextrose group than in the fasting group (F = 3.20, ES = 0.045, P = .04). Furthermore, between-group analysis revealed statistically significant decreases in both pre- and postoperative fatigue (P < .001). Although the interaction between POCL intervention and time did not show a statistically significant reduction in weakness (F = 2.39, ES = 0.03, P = .10), the between-group analysis revealed a significant decrease in weakness during both the preoperative and postoperative periods (P < .05). No significant improvement was observed in functional mobility (5.83 ± 2.86 vs 5.26 ± 3.59; P = .46), length of ICU stay (1.43 ± 0.69 vs 1.69 ± 0.83; P = .16), or overall hospitalization duration (3.31 ± 0.58 vs 3.37 ± 0.54; P = .67). No postoperative pulmonary aspiration events were reported.

PODL, as a safe, cost-effective, and efficacious intervention, may improve perioperative symptoms such as dry mouth, fatigue, weakness, and postoperative sleep quality in orthopedic surgery patients. However, its limited effect on functional mobility, ICU length of stay, and overall hospitalization duration suggests that a more individualized approach may be necessary to optimize clinical outcomes.