Singh Ranju, Huligeri H Santoshkumar, Singh Pooja
Department of Anaesthesiology and Critical Care, Lady Hardinge Medical College and Associated Kalawati Saran Children Hospital, New Delhi, India.
Department of Oncoanesthesia, BLK Max Superspeciality Hospital, New Delhi, India.
Indian J Anaesth. 2024 Sep;68(9):815-820. doi: 10.4103/ija.ija_1147_23. Epub 2024 Aug 16.
The time paediatric patients should resume oral intake after surgery is still ill-defined. No specific evidence suggests that the usual practice of postoperative fasting of 4-6 h to reduce postoperative nausea and vomiting (PONV) is beneficial. The primary objective of this study was to assess the occurrence of PONV with early oral feeding compared to conventional feeding in children undergoing daycare surgery under general anaesthesia.
A randomised controlled trial was conducted in 300 children undergoing daycare surgery under general anaesthesia. Children were randomised into the early feeding group (Group EF, = 150) or the conventional feeding group (Group CF, = 150). Group EF received carbohydrate-containing oral fluids when the child demanded feed in the postoperative period. Group CF received oral fluids 4 h post-anaesthesia. All patients were monitored for occurrence of PONV, postoperative pain, duration of hospital stay and parental satisfaction. The incidence of PONV was compared using the Chi-squared test, while other continuous variables were compared using the Student's -test.
Both groups were comparable regarding PONV (12% in Group EF vs. 18.7% in Group CF, = 0.109). The Face, Legs, Activity, Cry, Consolability scores were significantly lower in Group EF at 0 min ( = 0.011), 30 min ( = 0.001) and 1 h ( < 0.001). Patients in Group EF had a significantly shorter duration of hospital stay, that is, 6.31 [standard deviation (SD): 3.52] [95% confidence interval (CI): 1.45-12.24] h in EF versus 10.13 (SD: 2.99) (95% CI: 5.12-16.33) h in CF ( < 0.001). Parents of the children in Group EF had significantly better parental satisfaction scores ( < 0.001).
Early postoperative feeding in children undergoing lower abdominal, non-gastrointestinal surgery under general anaesthesia does not increase the incidence of PONV.
小儿患者术后应何时恢复经口进食仍不明确。没有具体证据表明术后常规禁食4 - 6小时以减少术后恶心呕吐（PONV）是有益的。本研究的主要目的是评估在全身麻醉下行日间手术的儿童中，与传统喂养相比，早期经口喂养时PONV的发生情况。
对300例全身麻醉下行日间手术的儿童进行了一项随机对照试验。儿童被随机分为早期喂养组（EF组，n = 150）或传统喂养组（CF组，n = 150）。EF组在术后患儿有进食需求时给予含碳水化合物的口服液。CF组在麻醉后4小时给予口服液。监测所有患者PONV的发生情况、术后疼痛、住院时间及家长满意度。使用卡方检验比较PONV的发生率，而其他连续变量使用学生t检验进行比较。
两组在PONV方面具有可比性（EF组为12%，CF组为18.7%，P = 0.109）。在0分钟（P = 0.011）、30分钟（P = 0.001）和1小时（P < 0.001）时，EF组的面部、腿部、活动、哭闹、安慰度评分显著更低。EF组患者的住院时间显著更短，即EF组为6.31 [标准差（SD）：3.52] [95%置信区间（CI）：1.45 - 12.24]小时，而CF组为10.13（SD：2.99）（95% CI：5.12 - 16.33）小时（P < 0.001）。EF组儿童的家长满意度评分显著更高（P < 0.001）。
全身麻醉下行下腹部非胃肠道手术的儿童术后早期喂养不会增加PONV的发生率。
