Data that have only recently become available show that preoperative admini
stration of carbohydrate to patients undergoing elective surgery has metabo
lic benefits postoperatively by reducing postoperative insulin resistance.
This metabolic change has been shown to be an independent factor explaining
the variation in length of stay. In addition, preliminary data suggest tha
t when the carbohydrates are given as a beverage 2-3 hours before the opera
tion, well being is improved pre- and postoperatively. This method has been
tested in a total of approximately 900 patients without any adverse events
reported, suggesting that this is safe to use. Lastly, a meta-analysis of
three prospective controlled trials indicates that length of stay is reduce
d by about 20% by preoperative carbohydrate compared with surgery in the ov
ernight fasted state. (C) 2001 Harcourt Publishers Ltd.