• Heli Helminen, Hanna Viitanen, and Juha Sajanti.
• Department of Surgery, Seinäjoki Central Hospital, Seinäjoki, Finland. heli.helminen@epshp.fi
• Eur J Anaesthesiol. 2009 Feb 1;26(2):123-7.

Background And ObjectiveWe studied the effect of three different fasting protocols on preoperative discomfort and glucose and insulin levels.MethodsTwo hundred and ten ASA I-III patients undergoing general or gastrointestinal surgery were randomly assigned to three groups: overnight intravenous 5% glucose infusion (1000 ml), carbohydrate-rich drink (400 ml) at 6-7 a.m., or overnight fasting. The subjective feelings of thirst, hunger, mouth dryness, weakness, tiredness, anxiety, headache and pain of each patient were questioned preoperatively using a visual analogue scale. Serum glucose and insulin levels were measured at predetermined time points preoperatively.ResultsDuring the waiting period before surgery, the carbohydrate-rich drink group was less hungry than the fasting group (P = 0.011). No other differences were seen in visual analogue scale scores among the study groups. Trend analysis showed increasing thirst, mouth dryness and anxiety in the intravenous glucose group (P < 0.05). The carbohydrate-rich drink group experienced decreasing thirst but increasing hunger and mouth dryness (P < 0.05). In the fasting group, thirst, hunger, mouth dryness, weakness, tiredness and anxiety increased (P < 0.05). Both intravenous and oral carbohydrate caused a significant increase in glucose and insulin levels.ConclusionIntravenous glucose infusion does not decrease the sense of thirst and hunger as effectively as a carbohydrate-rich drink but does alleviate the feelings of weakness and tiredness compared with fasting.

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