Impact of Preoperative Carbohydrate-loading on Postoperative Gastrointestinal Complications Following Bimaxillary Osteotomy

<p>  Background : Preoperative carbohydrate loading (CHO) is recommended to enhance recovery after elective surgery. However, most supporting data originate from studies conducted in fields of surgery other than oral and maxillofacial surgery.</p><p>  Methods : This retrospective cohort study explored the effect of CHO on the rate of postoperative complications, including the time to return of bowel function (ROBF) and the incidences of vomiting, hyperglycemia, and hypoproteinemia, in consecutive patients who underwent a Le Fort 1 and sagittal splitting ramus osteotomy under general anesthesia with total intravenous anesthesia at the Nihon University School of Dentistry Dental Hospital between October 2022 and June 2023. A multivariate linear regression analysis was used to investigate the relationship between CHO and the time to ROBF.</p><p>  Results : The final cohort included 87 patients. Forty-one patients (47%) consumed 400 mL of a 12.5% carbohydrate drink (50 g carbohydrate) between the time of waking and 2 hours before surgery. The remaining patients (n＝46, 53%) drank water only from the time of waking until at least 2 hours before surgery. The results showed that CHO decreased the number of postoperative days until ROBF (β, −0.72 ; 95% confidence interval, −1.18 to −0.26 ; P＝0.002). Sex, preoperative defecation frequency, and incidence of postoperative diarrhea were not significantly associated with the time until postoperative defecation.</p><p>  Conclusions : CHO reduces the time to ROBF, which may result in a reduced incidence of postoperative constipation and increased comfort after bimaxillary osteotomy, although the present assessment was limited by the relatively small patient cohort.</p>