Conference abstract

The effects of pre-operative carbohydrate loading on the metabolic response to surgery in a low resource setting

Pan African Medical Journal - Conference Proceedings. 2017:2(49).25 Dec 2017.
doi: 10.11604/pamj-cp.2017.2.49.94

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Keywords: Pre-operative carbohydrate, a low resource setting metabolic response, Cameroon
Oral presentation

The effects of pre-operative carbohydrate loading on the metabolic response to surgery in a low resource setting

Sylvie Njong1,&, Elroy Patrick Weledji1, Alain Chichom1

1Faculty of Health Sciences, University of Buea, Cameroon

&Corresponding author
Sylvie Njong, Faculty of Health Sciences, University of Buea, Cameroon

Abstract

Introduction: the stress response to surgery involves catabolism and gluconeogenesis resulting in postoperative hyper glycaemia. Post-operative hyper glycaemia is a risk factor for postoperative complications and pre-operative fasting further aggravates this response. A carbohydrate (CHO) drink instead of fasting is expected to decrease insulin resistance and reduce post-operative hyper glycaemia. The aim of this study was to assess the effect of the reduction of the pre-operative fasting period on post-operative hyper glycaemia and post-operative complications in open surgery.

Methods: a hospital-based prospective case control study of 70 patients scheduled for elective surgery were sampled to either a case (carbohydrate loaded) or a control (FAST) group. Postoperative hyper glycaemia and complications were the primary and secondary outcomes reported.

Results: 70 patients were recruited with 35 patients per group. 40(57.14%) were females and 30(42.86%) were males. The mean blood glucose on the first postoperative day was significantly higher in those who fasted (146.20±38.36mg/dl) than in those who received the energy drink (123.06±26.64mg/dl), p = 0.004. Postoperative infections were significantly higher in the control group than in the CHO group (31.43%; and 8.57%; 95% C.I: 1.2275-19.4715) p = 0.033. The mean length of hospital stay was longer in the FAST (12.54days±15.08) than in the CHO (9.17days±12.65) group although the difference was not statistically significant p = 0.3145. The mean age, surgery type and mean duration of surgery were significant between groups but not upon logistic regression for significant clinical and demographic variables.

Conclusion: pre-operative CHO loading is effective and safe in reducing post-operative hyper glycaemia and infection in open general surgery even in low resource area.