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Maltodextrin Versus Sugar Water Carbohydrate Loading and Gastric Volume in Geriatric Lower Limb Orthopedic Surgery

Sponsor: Udayana University • ClinicalTrials.gov ID: NCT07872683

Registry updated: 2026-10-14

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Description

Before surgery, patients are asked to fast so the stomach is empty and stomach contents cannot enter the lungs during anesthesia. Long fasting is uncomfortable and can raise blood sugar and stress responses in older adults. Giving a carbohydrate drink up to 2 hours before surgery is part of enhanced recovery (ERAS) programs. It is not clear whether a maltodextrin drink or sugar water leaves less fluid in the stomach of older patients. This randomized, double-blind study enrolls patients aged 60 years and older who are having elective lower limb orthopedic surgery under spinal or epidural anesthesia at Prof. Ngoerah General Hospital in Denpasar, Indonesia. Participants are assigned by chance to drink 400 mL of either a maltodextrin carbohydrate drink or sugar water 2 hours before anesthesia. The amount of fluid in the stomach is measured with bedside ultrasound before the drink and 2 hours after it. Blood glucose is measured before the drink, 2 hours after it and 6 hours after surgery. The neutrophil-lymphocyte ratio, a blood marker of inflammatory stress, is compared before surgery and 6 hours after surgery. The results are intended to show which drink is better suited to older surgical patients and to support safer and more comfortable fasting practice.

Interventions

Maltodextrin carbohydrate drink (Dietary supplement)
400 mL (4 x 100 mL) of ready-to-drink clear maltodextrin beverage (Maltodex, PT Finusoprima Farma Internasional). Per 100 mL: 50 kcal, 13 g carbohydrate of which 4 g sugars, 15 mg sodium, vitamin A and zinc at 15% of daily value each. Single dose, drunk within 15 to 30 minutes, 2 hours before anesthesia. Unlike the comparator it contains added vitamin A and zinc.
Sugar water (Dietary supplement)
400 mL of clear solution prepared by the hospital nutrition installation by dissolving about 50 g of sucrose (table sugar) in drinking water to a final volume of 400 mL (about 200 kcal, no fat, no protein). Single dose, drunk within 15 to 30 minutes, 2 hours before anesthesia.

Eligibility criteria

Inclusion Criteria: * Age 60 years or older with adequate cognitive function on brief cognitive screening * ASA physical status II or III * Elective lower extremity orthopedic surgery under neuraxial anesthesia Exclusion Criteria: * Emergency or urgent surgery * Unstable hemodynamics * Diagnosed gastrointestinal tract pathology * History of bariatric surgery * Dressing, wound cover or corset over the abdomen that prevents gastric ultrasound * Use of a proton pump inhibitor, H2 antagonist or drug affecting gastrointestinal motility (for example metoclopramide, loperamide) in the past week * Unable to lie in the lateral decubitus position * Body mass index below 19 or 35 kg/m2 and above * Refuses to take part after informed consent

Conditions

Respiratory Aspiration Hyperglycemia Inflammation

Locations

Prof. Dr. I.G.N.G. Ngoerah General Hospital (RSUP Prof. Dr. I.G.N.G. Ngoerah) — Denpasar, Bali, Indonesia

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Official Source

Data sourced from ClinicalTrials.gov, a service of the U.S. National Institutes of Health.

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