Effect of Preoperative Oral Carbohydrate Intake on Quality of Recovery in Elderly Patients Undergoing Total Knee Arthroplasty

OBJECTIVE: To assess the effect of preoperative oral carbohydrate intake on the quality of recovery in elderly patients undergoing total knee arthroplasty (TKA), using the Quality of Recovery-15 (QoR-15) questionnaire. STUDY DESIGN: A randomised, placebo-controlled study. Place and Duration of the Study: Department of Anaesthesiology and Intensive Care Medicine, Karaman Training and Research Hospital, Karaman, Turkiye, from June 2024 to January 2025. METHODOLOGY: One hundred patients aged ≥65 years scheduled for TKA were randomly assigned to either a placebo group (PG, n = 50) or an oral carbohydrate group (OCG, n = 50). Participants in the PG received 300 mL of water for 3 hours before surgery, while those in the OCG received 300 mL of a liquid carbohydrate drink 3 hours preoperatively. The primary outcome measure was the QoR-15 score assessed 24 hours postoperatively. Total QoR-15 scores were normally distributed and compared between groups using an independent samples t-test. Other secondary outcomes, including patient well-being, delirium frequency (assessed using the Confusion Assessment Method and the Mini-Mental State Examination), and sleep quality, were also evaluated. RESULTS: The QoR-15 scores were significantly higher in the group OCG (121.94 ± 9.4) than in the PG (115.76 ± 12.26) on the first day postoperatively (6.1; 95% CI: 1.8 to 10.5, p = 0.006). The parameters indicating patient well-being (thirst, dry mouth, fatigue, nausea, and vomiting) were lower in the PG than in the OCG after surgery. CONCLUSION: Oral carbohydrate intake before surgery could improve the quality of postoperative recovery, well-being, and satisfaction of elderly patients undergoing TKA 24 hours after surgery. KEY WORDS: Knee arthroplasty, Oral carbohydrate intake, Delirium, Fasting, Quality of recovery.