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Authors, year | Country | Anesthesia | Carbohydrate group | Control group | Outcomes |
Placebo group | Fasting group |
Sample size | Intervention | Sample size | Intervention | Sample size | Intervention |
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Ghorashi et al. 2014 [18] | Iran | General anesthesia | 267 | Oral 150 ml of 10% traditional sugar plum 1 h preoperatively | — | — | 144 | Received nothing | Rate of regurgitation and aspiration |
Razieh Khalooei Fard, 2017 | Iran | Spinal anesthesia | 45 | Oral 800 ml of 12.5% carbohydrates (50 kcal/100 ml) between 20 and 24 hours before surgery and 400 ml of the same drink 2 hours before the anesthesia | 46 | Oral 800 ml of flavored water with lemon (0 kcal/100 ml) between 20 and 24 hours before surgery and 400 ml of the same drink 2 hours before the anesthesia | — | — | Time to first breastfeeding after surgery, frequency, and duration of breastfeeding for up to 36 hours after the surgery |
Wendling et al. 2020 [23] | USA | Spinal anesthesia | 15 | Oral 710 mL of 14% carbohydrates (56.3 kcal/100 mL) the evening prior to surgery and 355 mL 2–4 hours before the anesthesia start time | 17 | Oral 710 mL of 5.9% carbohydrates (22.5 kcal/100 mL) the evening prior to surgery and 355 mL 2–4 hours before the anesthesia | 15 | Fasted after midnight the night before surgery and no oral intake at least 8 hours prior to surgery | Visual Analogue Scale (VAS) for hunger, thirst and well-being outcomes, blood loss, aspiration, breastfeeding, neonatal outcomes, and maternal complications |
Clark, 2020 | UK | Not mentioned | 94 | Oral 800 ml of 12% carbohydrate on the previous evening and another 400 ml 2 h prior to surgery. An extra 400 ml or further 400 ml 2 hours prior to surgery | 90 | Oral 800 ml of water on the previous evening and another 400 ml 2 h prior to surgery. An extra 400 ml or further 400 ml 2 hours prior to surgery | — | — | Urinary ketone level, dominant hand grip strength, anxiety score, hunger and thirst scores, and length of hospital stay |
He et al. 2021 [19] | China | Spinal anesthesia | 30 | Oral 400 ml of 12.5% carbohydrate (50.9 kcal/100 mL) 2 hours before the surgery | 29 | Oral 400 ml clear water 2 hours before the surgery | 29 | Fasting for 10.5 hours | Postoperative insulin resistance, plasma glucose and insulin levels, VAS for thirst and hunger, the occurrences of nausea and vomiting, time of flatus, postoperative fever, Apgar score, and blood glucose level |
Ningning Liu, 2020 | China | Epidural anesthesia, a combination of epidural and lumbar anesthesia | 43 | Oral 300 mL 7.5% carbohydrate (30.5 kcal/100 mL) 2 hours before induction of anesthesia | 42 | Oral 300 mL warm water 2 hours before induction of anesthesia | — | — | Blood glucose, serum insulin, hunger and thirst scores, and gastrointestinal function parameters |
Yuan Shi, 2020 | China | Continuous epidural anesthesia | 25 | Oral 300 mL of 14.2% carbohydrate | 25 | Oral 300 mL of water | 25 | Fasting for 6 hours | VAS for thirst, hunger, and anxiety level, the gastric antral cross-sectional areas, insulin resistance, blood glucose, and insulin levels |
Yang et al. 2021 [21] | China | Combined spinal-epidural anesthesia | 39 | Oral 300 mL of 14.1% carbohydrate (57.6 kcal/100 mL) at 2 hours before surgery | 40 | Oral 300 mL of distilled water at 2 hours before surgery | 39 | Fasting, drinking, or eating on the day of the operation | Core body temperature and body surface temperature, the incidence of intraoperative hypotension, vomiting, and shivering, amount of bleeding |
Cheng et al. 2022 [15] | China | Combined spinal-epidural anesthesia | 38 | Oral 300 mL of 14.1% carbohydrate (57.6 kcal/100 mL) 2 h before the operation | 37 | Oral 300 mL of distilled water 2 h before the operation | 37 | Fasting, drinking, or eating on the day of the operation | The time to colostrum and exhaust, the incidence of vomiting, VAS of pain, vaginal bleeding volume, and complications (urinary retention, fever, or intestinal obstruction) |
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