Effects of Preoperative Honey Drink on Gastric Content, Perioperative Discomfort and Insulin Resistance in Patients Undergoing Open Colorectal Surgery a Randomized, Controlled Trial

Abstract

Background and Aims: Preoperative fasting and surgery cause uncomfortable condition, metabolic stress and insulin resistance for the patient. A recent study in colorectal patients indicates that even small elevations of insulin resistance increase the risk of complications. Preoperative carbohydrate can reduce perioperative discomfort and insulin resistance. We investigated the effects of honey as preoperative carbohydrate-rich drink on the residual gastric contents, perioperative discomfort, and insulin resistance. Methods: Randomized, prospective, controlled study. Thirty colorectal cancer patients who underwent elective open colorectal surgery were randomized and divided into the treatment or control group. Patients in treatment group (n = 15) received 250 ml water containing 50 ml honey on the evening and 2-3 hours preoperatively. Control patients (n = 15) underwent overnight fasting. Three different discomfort variables (thirst, hunger and tiredness), residual gastric content, plasma glucose, insulin concentrations and insulin resistance index were recorded during the perioperative period. Results: Patient and operative characteristics did not differ between groups. There was no statistical difference between the two groups with respect to gastric residue content. Subjective well-being was significantly better in the treatment group. Plasma glucose, serum insulin levels and insulin resistance index were found to remain significantly lower in the treatment group. Conclusion: The preoperative honey drink does not appear to alter the volume of residual gastric contents, suggesting that this is safe procedure. Preoperative honey intake is advantageous due to reducing perioperative discomfort and insulin resistance.