Effect of preoperative oral carbohydrate on postoperative delirium in elderly patients undergoing lower extremity orthopedic surgery: a prospective randomized trial

Background Postoperative metabolic disorders and inflammatory responses are closely associated with postoperative delirium (POD). Preoperative oral carbohydrate intake can alleviate postoperative insulin resistance and the inflammatory response. This study aimed to evaluate the effects of preoperative oral carbohydrate intake on the incidence of POD in older patients undergoing lower limb orthopedic surgery. Methods Eighty patients were randomly assigned to oral intake of 200 mL carbohydrate solution (Group CHO) 2 h before surgery or fasting for 8 h before surgery (Group C). The primary outcome was the incidence of POD. Fasting plasma glucose, interleukin (IL)-6, and C-reactive protein (CRP) levels were assessed before surgery and 1, 3, and 5 days after surgery (D1, D3, and D5). ResultsThe incidence of POD in Group CHO was lower than that in Group C (P = 0.005). Blood glucose, IL-6 and CRP levels of Group CHO were significantly lower than those of Group C on D1 and D3 (P < 0.05). Conclusions Preoperative oral carbohydrate intake can reduce the incidence of POD in older patients by ameliorating postoperative metabolic disorders and reducing inflammatory responses. Trial registrationChiCTR2300070154, Date of registration: 03/04/2023.