Carbohydrate Fluids for Postoperative Nausea and Vomiting

(PONV Trial)

Overseen By Radhika Chigurupati, DMD MS

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: Boston Medical Center

Must not be taking: Scopolamine

Disqualifiers: Non-English, GERD, Diabetes, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: 1

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial aims to determine if drinking a carbohydrate-rich fluid, such as apple juice, before surgery can reduce post-operative nausea and vomiting. Researchers seek to discover if this carbohydrate drink can also shorten hospital stays, lower anxiety, and decrease the need for medications after surgery. Participants will either drink the carbohydrate fluid or fast before their surgery. The study seeks healthy individuals undergoing specific jaw surgeries scheduled before noon, who do not have a history of motion sickness or gastrointestinal issues. As an unphased trial, this study offers participants the chance to contribute to research that could enhance surgical recovery for future patients.

Will I have to stop taking my current medications?

The trial information does not specify if you need to stop taking your current medications. However, if you have a history of gastroesophageal reflux disease, motion sickness, or diabetes, you may not be eligible to participate.

What prior data suggests that pre-operative carbohydrate fluids are safe for reducing postoperative nausea and vomiting?

Research has shown that drinking carbohydrate drinks, such as apple juice, before surgery is safe. One study found that these drinks increased patient comfort and satisfaction without causing harm. Another study demonstrated that this method can be safely combined with other pain relief options. Additionally, some studies suggest these drinks aid in better recovery after surgery.

Overall, evidence indicates that drinking a carbohydrate drink before surgery is well-tolerated and does not cause serious side effects. This information can reassure those considering participation in a clinical trial involving pre-operative carbohydrate drinks. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about using a carbohydrate drink before surgery to tackle postoperative nausea and vomiting because it introduces a simple yet innovative approach. Unlike the standard practice of fasting, which can leave patients feeling weak and nauseous, this carbohydrate drink provides energy and might stabilize blood sugar levels, potentially reducing nausea. By offering a nutritional boost before surgery, the drink could help patients recover more comfortably and quickly, making it a promising alternative to traditional fasting.

What evidence suggests that pre-operative carbohydrate fluids are effective for reducing postoperative nausea and vomiting?

This trial will compare the effects of a preoperative carbohydrate drink with preoperative fasting on postoperative nausea and vomiting. Studies have shown that consuming carbohydrate-rich drinks before surgery can sometimes reduce nausea and vomiting afterward. For instance, in a study with 904 patients, those who consumed these drinks experienced less nausea and vomiting. Another study found that these drinks, when combined with other pain relief methods, helped reduce these symptoms in patients with obesity. However, not all research agrees, as some studies found no significant effect. Overall, these drinks might help reduce nausea and vomiting after surgery, especially for certain groups of patients. ^{2 3 4 6 7}

Who Is on the Research Team?

Angeline Nguyen, DMD

Principal Investigator

Boston Medical Center, Oral and Maxillofacial Surgery

Are You a Good Fit for This Trial?

This trial is for patients undergoing oral and maxillofacial surgery at Boston Medical Center who can safely consume a carbohydrate drink before their operation. It's not specified who cannot join, but typically those with allergies to the study materials or conflicting medical conditions would be excluded.

Inclusion Criteria

Operating room (OR) time scheduled prior to 12 pm

I am healthy and have a low to moderate risk for complications during surgery.

Exclusion Criteria

I will use a scopolamine patch before surgery.

Non-English speaking/poor English comprehension

I am having jaw surgery and may also have surgery on my jaw joint, fat grafting, liposuction, or nose reshaping.

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Pre-operative

Participants receive pre-operative carbohydrate fluids or undergo fasting before surgery

1 day

1 visit (in-person)

Surgery and Immediate Post-operative

Participants undergo surgery with the ERAS protocol and are monitored for PONV intensity and incidence

6-24 hours

In-patient stay

Follow-up

Participants are monitored for safety and effectiveness after treatment, including PONV assessment and hospital discharge

1-2 days

What Are the Treatments Tested in This Trial?

Interventions

• Carbohydrate drink

Trial Overview The study tests if drinking more than 50 grams of carbohydrates (like apple juice) before surgery can reduce nausea and vomiting after the operation. Patients will follow an Enhanced Recovery After Surgery protocol to limit other factors that could affect results.

How Is the Trial Designed?

Group I: Preoperative carbohydrate drink Experimental Treatment 1 Intervention

Participants randomized into this group will receive a carbohydrate drink before surgery.

Group II: Preoperative fasting Active Control 1 Intervention

Participants randomized into this group will be fasting/nothing by mouth (NPO) before surgery.

Who Is Running the Clinical Trial?

Boston Medical Center

Lead Sponsor

Trials

410

Recruited

890,000+

Citations

1. pubmed.ncbi.nlm.nih.gov pubmed.ncbi.nlm.nih.gov/40482936/

Can Preoperative Carbohydrate Drinks and Multimodal ... Results: Preoperative carbohydrate drinks and multimodal analgesia, compared with the control group, did not have a significant effect on PONV.

2. medrxiv.org medrxiv.org/content/10.1101/2025.06.16.25329650v1.full-text

The effectiveness of preoperative oral carbohydrate ... Severity of postoperative nausea and vomiting​​ The overall pooled effect from 904 patients showed oral carbohydrate loading reduced PONV ...

3. sciencedirect.com sciencedirect.com/science/article/abs/pii/S0883540325006564

Can Preoperative Carbohydrate Drinks and Multimodal ... The combination of preoperative carbohydrate drinks and multimodal analgesia effectively reduced PONV after TKA, but only in patients who had obesity.

4. clinicaltrials.gov clinicaltrials.gov/study/NCT03380754?term=PENTETIC%20ACID&rank=8

Effects of Preoperative Carbohydrate Rich Drinks on ... The aim of this study is to investigate the effect of preoperative carbohydrate rich drinks on postoperative nausea and vomiting in total knee arthroplasty.

5. onlinelibrary.wiley.com onlinelibrary.wiley.com/doi/10.1007/s00268-023-07145-8

Effect of Preoperative Carbohydrate Drink and ... Conclusion. Preoperative carbohydrate drinks and early postoperative CG reduces the severity of PONV and requirement of antiemetics in patients ...

6. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC3897064/

Preoperative carbohydrate nutrition reduces postoperative ... This study showed that pre-operative carbohydrate drink may be used safely and also improves patient's satisfaction and comfort in patients undergoing ...

7. ashp.org ashp.org/-/media/assets/policy-guidelines/docs/endorsed-documents/endorsed-documents-fourth-consensus-guidelines-postop-nausea-vomiting.pdf

Fourth Consensus Guidelines for the Management of ... This consensus statement presents a comprehensive and evidence-based set of guidelines for the care of postoperative nausea and vomiting ...