Chen, Lua Bee
(2020)
The Effect of Carbohydrate Loading On Gastric Residual Volume And Hunger Score: A Single Blind, Randomised Controlled Trial Study.
Masters thesis, Universiti Sains Malaysia.
Abstract
Background
Carbohydrate loading is one of the key steps in Enhanced Recovery After Surgery (ERAS)
protocol which aims to expedite post-operative recovery. Body response to surgery and
prolong fasting by releasing of stress hormone and inflammatory marker leads to insulin
resistance and catabolic state.
Objective
Effectiveness of carbohydrate loading versus plain water on gastric residual volume and
patient’s well being.
Methodology
This is a single centre, single-blinded, parallel, placebo-controlled, stratified randomized
controlled trial at Endoscopy Unit, Hospital Universiti Sains Malaysia(HUSM) from May
2019 to March 2020. Patients older than 18 years old were randomly assigned to either
carbohydrate loading (237mls of resource) or control group (250mls of plain water).
Randomization sequence was computer generated and allocation sequence was sealed
in sequentially numbered and opaque envelopes. The drinks were served 2 hours prior
to OGDS procedure. During the OGDS, all the gastric contents were aspirated into a
reservoir bottle and recorded as gastric residual volume for comparison later. The
patients’ well-being (hunger, thirst, anxiety, tiredness, and weakness) were assessed
using visual analogue scale (VAS) before (pre) and after (post) drink consumption.
Results
78 patients were randomised and analysed with equal allocation between groups. Their
mean age was 49 years old with standard deviation (SD) of 14.3 years old. The means
(SD) gastric residual volume in carbohydrate loading group was 58.54(52.98)mls,
whereas 13.97(14.93)mls in plain water group. There was significantly more gastric
residual volume in carbohydrate group (p<0.001). Carbohydrate loading group
significantly showed reduction in VAS score of hunger (p=0.043) and thirst (p=0.021).
There was improvement of VAS score for anxiety, tiredness, and weakness over time in
carbohydrate loading group compared with plain water group, but not statistically
significant.
Conclusion
Carbohydrate loading is associated with higher gastric residual volume compared to
plain water. However, they were associated with significantly better well-being.
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