Preoperative Carbohydrate Loading
Required for ALL patients the night before surgery.
Protocol
Consume 100 g of complex carbohydrates the evening before surgery (typically between 8:00–10:00 PM). This reduces insulin resistance, preserves glycogen stores, and decreases postoperative nausea and catabolism.
This is consistent with ERAS Society guidelines and supported by anesthesia literature demonstrating reduced preoperative anxiety and improved patient comfort when overnight fasting is shortened via carbohydrate-rich clear fluids.
Recommended Options
Evidence-based carbohydrate drinks used in perioperative ERAS protocols:
ClearFast® PreOp
Purpose-built preoperative carbohydrate drink (maltodextrin-based, clear). Widely used in ERAS protocols across orthopaedic, colorectal, and bariatric surgery. FDA-cleared.
Serving: 2 bottles (12 oz each) = ~100 g complex carbohydrates.
Ensure® Pre-Surgery
Clear, carbohydrate-rich nutritional drink designed for preoperative use. Contains maltodextrin with no fat or protein to ensure rapid gastric emptying.
Serving: 2 cartons = ~100 g carbohydrates. Check label for exact values.
Gatorade® (Regular, non-red)
Readily available alternative. Contains simple sugars (sucrose, dextrose) rather than complex maltodextrin. Acceptable when dedicated preop drinks are unavailable. Avoid red-colored varieties (aspiration risk visualization).
Serving: approximately 48 oz (1.4 L) of regular Gatorade = ~100 g carbohydrates.
Important Notes
- The 100 g target refers to carbohydrate content, not total fluid volume. Verify nutrition labels.
- Diabetic patients: coordinate with anesthesia regarding glycemic management and timing.
- At this time, we are not implementing the 2-hour preoperative 50 g carbohydrate bolus (day-of-surgery loading). This may be added in a future protocol update.
- Clear liquids are acceptable up until the facility's NPO cutoff (typically 2 hours pre-anesthesia for clear fluids per ASA guidelines).