Author Credentials

Dr Oya GÜMÜŞKAYA, PhD. RN. a, Prof. Ikbal ÇAVDAR, PhD. RN. b, Dr. Çiğdem AKYOL BEYOĞLU. MD. Spec. c

a Istanbul University-Cerrahpaşa, Institute of Higher Education, Doctorate of Surgical Nursing Program, Avcilar, Istanbul, Turkey Oyagumuskaya@yahoo.com; Oya.gumuskaya@newcastle.edu.au

b Istanbul University-Cerrahpaşa, Florence Nightingale Faculty of Nursing, Department of Surgical Nursing, Sisli, Istanbul, Turkey ikbal@istanbul.edu.tr +90 212 224 2618

c Istanbul University-Cerrahpaşa, Cerrahpaşa Faculty of Medicine, Department of Anesthesia and Reanimation, Fatih, Istanbul, Turkey cigdem.akyol@istanbul.edu.tr +90 212 414 30 00 21876

Corresponding Author:


Present Address:

The University of Newcastle (UON)

College of Health, Medicine and Wellbeing / School of Nursing and Midwifery

T. 61+ (02) 498 54092 Fax. 61+ 02 4349 4538 M. +61 408 999 592

W: https://www.newcastle.edu.au/profile/oya-gumuskaya

BE315 BE Building 10 Chittaway Rd, Ourimbah NSW 2258 Australia Oyagumuskaya@yahoo.com; Oya.gumuskaya@newcastle.edu.au



Post-operative nausea and vomiting (PONV) is the secondmost common post-operative complication. Prolonged pre-operative fasting is common in Australia despite guidelines recommending reduced fasting to improve patient outcomes, such as PONV. Commercially prepared preoperative oral carbohydrate (OC) drinks may be used to reduce fasting time. In this study commercial products were replaced with honey, an inexpensive and common food item.


Partially blinded, four parallel arms randomised controlled noninferiority trial compared pre-operative OC loading with overnight fasting.


Adult elective laparoscopic cholecystectomy and thyroidectomy patients having two or more risk factors for PONV were allocated into intervention and control groups by simple randomisation. The intervention group ingested 60g of honey in 100 ml of water at least two hours before surgery as pre-operative OC loading to reduce PONV. Participants and assessors to the group assignment were blinded to the study outcomes. Early PONV (0–6 hours) was measured with Rhodes index of nausea, vomiting and retching (R-INVR) and a numeric rating scale (NRS).


The four groups (N = 142) were control and intervention groups of thyroidectomy patients (n = 72: C = 37, I = 35), and control and intervention groups of laparoscopic cholecystectomy patients (n = 70: C = 37, I = 33) and had similar distributions of variables. The estimated effect size was 140 with a 95 percent confidence interval. The PONV incidence (Pearson χ2 = 4.54; df = 1; p = 0.03) and severity were significantly lower in the laparoscopic cholecystectomy intervention group (R-INVR: Mann–Whitney U = 446.5; p = 0.01; NRS: Mann–Whitney U = 444.5; p = 0.01) and results were not conclusive in the thyroidectomy group (NRS: Mann–Whitney U = 629.5; p = 0.95; R-INVR: Mann–Whitney U = 629.5; p = 0.76).


Honey could be recommended as an inexpensive pre-operative OC to reduce PONV in adult patients receiving general anaesthesia.

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This work is licensed under a Creative Commons Attribution 4.0 License.