Huh Jaewon, Koo Jung-Min, Kim Minju, Choi Hoon, Park Hyung-Joo, Rim Gong-Min, Hwang Wonjung
Department of Anesthesiology and Pain Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea.
Department of Thoracic and Cardiovascular Surgery, Nanoori Hospitals, Seoul 06048, Republic of Korea.
J Clin Med. 2024 Jun 19;13(12):3593. doi: 10.3390/jcm13123593.
: Preoperative fasting guidelines traditionally aim to reduce pulmonary aspiration risk. However, concerns over the adverse effects of prolonged fasting have led to exploring alternatives. This study aimed to investigate the impact of preoperative clear liquid intake on postoperative outcomes in children undergoing minimally invasive repair of pectus excavatum (MIRPE). : A prospective randomized controlled study was conducted on children aged 3-6 years scheduled for elective MIRPE. Patients were randomized into either a routine overnight fasting group (NPO) or a clear liquid group. The incidence and severity of emergence delirium (ED) were assessed using Pediatric Anesthesia Emergence Delirium (PAED) and Watcha scales at recovery room. Postoperative pain scores and opioid requirements were evaluated at intervals of 1-6 h, 6-12 h, and 12-24 h after surgery. : Fasting time was 178.6 ± 149.5 min and 608.9 ± 148.4 min in the clear liquid group compared and NPO group, respectively. The incidence of ED, measured by PAED and Watcha scales, was lower in the clear liquid group (PAED score ≥ 12: 55.6% vs. 85.2%, = 0.037; Watcha score ≥ 3: 51.9% vs. 85.2%, = 0.019). The highest PAED score recorded in the recovery room was significantly lower in the clear liquid group (11.4 ± 2.8 vs. 14.6 ± 2.8, < 0.001). Clear liquid group showed significantly lower pain scores at 1-6, 6-12, and 12-24 h postoperatively. Additionally, clear liquid group had lower opioid requirement at 1-6 and 6-12 h postoperatively. : Preoperative clear liquid consumption was associated with a lower incidence of ED in pediatric patients undergoing MIRPE.
传统上，术前禁食指南旨在降低肺误吸风险。然而，对长时间禁食不良反应的担忧促使人们探索替代方案。本研究旨在调查术前饮用清液对接受漏斗胸微创修复术（MIRPE）儿童术后结局的影响。
对计划接受择期MIRPE的3至6岁儿童进行了一项前瞻性随机对照研究。患者被随机分为常规夜间禁食组（禁食）或清液组。在恢复室使用小儿麻醉苏醒谵妄（PAED）和Watcha量表评估苏醒谵妄（ED）的发生率和严重程度。术后分别在术后1 - 6小时、6 - 12小时和12 - 24小时评估疼痛评分和阿片类药物需求量。
清液组和禁食组的禁食时间分别为178.6±149.5分钟和608.9±148.4分钟。用PAED和Watcha量表测量，清液组的ED发生率较低（PAED评分≥12：55.6%对85.2%，P = 0.037；Watcha评分≥3：51.9%对85.2%，P = 0.019）。清液组在恢复室记录的最高PAED评分显著更低（11.4±2.8对14.6±2.8，P < 0.001）。清液组在术后1 - 6小时、6 - 12小时和12 - 24小时的疼痛评分显著更低。此外，清液组在术后1 - 6小时和6 - 12小时的阿片类药物需求量更低。
术前饮用清液与接受MIRPE的儿科患者ED发生率较低相关。
