Dhar Mridul, Rawat Jyoti, Payal Yashwant S, Agrawal Sanjay, Sharma Ruhi, Gupta Vaishali
Department of Anaesthesiology, All India Institute of Medical Sciences, Rishikesh, India.
Department of Anaesthesiology, Subharti Hospital and Medical College, Dehradun, India.
Indian J Anaesth. 2025 Apr;69(4):365-371. doi: 10.4103/ija.ija_1127_24. Epub 2025 Mar 13.
Early feeding or oral hydration post-surgery in paediatric patients has conventionally not been encouraged, with fasting periods ranging from 3 to 6 h. The primary objective of this study was to compare the Face, Legs, Activity, Cry, Consolability (FLACC) score as a surrogate for patient satisfaction in younger children between those who received early versus delayed postoperative feeding/hydration. Secondary objectives were to compare the incidence of complications, perioperative clinical parameters and parental satisfaction.
A single-blind, randomised trial was conducted in children of both genders, aged 1-5 years, undergoing elective surgery. Children were randomly allocated using sealed envelopes to receive either early hydration (EH) within 30 min of arrival to the post-anaesthesia care unit (PACU) or delayed standard hydration (SH) after 2 h. A rescue dose of fentanyl was given if the FLACC score was ≥6 at any time in PACU. The primary outcome was the FLACC score in PACU after 1 h. Statistical tests used were the unpaired -test for normally distributed data, Mann-Whitney test for non-normally distributed data and Fisher's exact test for categorical variables. < 0.05 was considered significant.
Out of the initially randomised 66 patients, 61 were finally analysed. Demographic and perioperative parameters were similar in both groups. FLACC score after 1 h in PACU was significantly lower in Group EH [1 (0.25-2)] than in Group SH [2 (1-3)] ( = 0.028). Parental satisfaction was higher in Group EH. There were no major complications.
Early postoperative oral hydration is efficacious and safe compared to standard delayed feeds in children undergoing elective surgery.
传统上不鼓励小儿患者术后早期进食或口服补液，禁食期为3至6小时。本研究的主要目的是比较接受术后早期与延迟进食/补液的年幼儿童中，以面部、腿部、活动、哭闹、可安慰性（FLACC）评分作为患者满意度的替代指标。次要目的是比较并发症的发生率、围手术期临床参数和家长满意度。
对年龄在1至5岁、接受择期手术的男女儿童进行了一项单盲随机试验。使用密封信封将儿童随机分配，使其在到达麻醉后护理单元（PACU）后30分钟内接受早期补液（EH），或在2小时后接受延迟标准补液（SH）。如果PACU中任何时间的FLACC评分≥6，则给予一剂抢救剂量的芬太尼。主要结局是PACU中1小时后的FLACC评分。所使用的统计检验为：对于正态分布数据采用不成对t检验，对于非正态分布数据采用曼-惠特尼U检验，对于分类变量采用费舍尔精确检验。P<0.05被认为具有统计学意义。
在最初随机分组的66例患者中，最终分析了61例。两组的人口统计学和围手术期参数相似。PACU中1小时后的FLACC评分，EH组[1（0.25 - 2）]显著低于SH组[2（1 - 3）]（P = 0.028）。EH组的家长满意度更高。未发生重大并发症。
与择期手术儿童的标准延迟喂养相比，术后早期口服补液有效且安全。
