The effectiveness of preoperative oral carbohydrate loading on postoperative nausea and vomiting in adults receiving total intravenous anaesthesia compared to inhalational anaesthesia: A systematic review and meta-analysis
Authors' conclusion
Oral carbohydrate loading reduces the severity of PONV and pain, regardless of the anaesthesia approach, compared to prolonged fasting.
Study context
- Population
- Adults (≥18 years) undergoing elective surgery under total intravenous anaesthesia (TIVA) or inhalational GA26 studies, 25 in meta-analyses
- Participants
- 2,491 adults
- Comparison
- Carbohydrate loading vs Fasting
- Outcome
- PONV (risk and severity)
Methodological detailsrandom effects meta-analyses, Cochrane ROB-2 risk of bias assessment
- Random effects meta-analyses
- Cochrane ROB-2 risk of bias assessment
Pooled result
As reported in the abstract
PONV, pooled across both anaesthesia approaches
Carbohydrate loading vs FastingSMD (95 % CI)
Severity of PONV; I2 = 62.09 %
−0.46(−0.68 to −0.24)
- Risk of postoperative nausea and vomiting (PONV); I2 = 51.11 %
- log RR −0.35 (95 % CI −0.62 to −0.08)
Further pooled results
| Outcome | MD (95 % CI) | |
|---|---|---|
| Pain severityI2 = 83.98 % | −0.69 (−1.13 to −0.25) | |
| −1.5−1−0.500.5Difference (linear scale) |
PONV by anaesthesia approach (subgroup)
- Risk of PONV reduced with inhalational anaesthesia but not with TIVA; reduction in severity more significant in TIVA
Original publication
The effectiveness of preoperative oral carbohydrate loading on postoperative nausea and vomiting in adults receiving total intravenous anaesthesia compared to inhalational anaesthesia: A systematic review and meta-analysis. J Clin Anesth. Published 16 November 2025. doi:10.
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