Eighty elderly patients undergoing hip or knee replacement surgery were randomized to receive either a 200 mL oral carbohydrate drink 2 hours before surgery (Group CHO, n=40) or to undergo standard fasting for 8 hours preoperatively (Group C, n=40). The primary outcome was the incidence of postoperative delirium (POD). Secondary outcomes included serum blood glucose, interleukin-6 (IL-6), and C-reactive protein (CRP) levels, as well as postoperative complications such as thirst, nausea, and vomiting. Outcomes were assessed up to 5 days postoperatively. Overall, the results revealed a significantly lower incidence of POD in the CHO group (7.5%) compared to the control group (32.5%), along with reduced postoperative glucose and inflammatory marker levels. These findings suggest that preoperative carbohydrate loading may mitigate POD through improved metabolic and inflammatory control.