Early oral intake after arthroscopic surgery under spinal anesthesia

We investigated the tolerability of early oral feeding (EOF) and its effects on the recovery of bowel function after spinal anesthesia.

Thirty-one healthy adult patients undergoing knee arthroscopy or arthroscopic surgeries were randomly assigned to either the EOF group (n = 16) or the nil per os (NPO, n = 15) group. Spinal anesthesia was performed using hyperbaric tetracaine solution in all patients. Patients in the EOF group were allowed free access to solid and liquid food immediately after surgery before analgesia from spinal tetracaine resolved. Oral intake was prohibited for 24 h after completion of surgery in the NPO group.

Two patients in each group were mildly nauseated without the need for treatment. While degree of appetite determined by a visual analog scale before the first meal and time to the first gas emission showed no significant differences between groups, the median time to the first defecation in the EOF group (20.6 h) was significantly shorter than that of the NPO group (33.5 h, P = 0.005). No other complications associated with anesthesia, surgery, or EOF were noted.

Our results suggest that the restriction of EOF after surgery not involving the gastrointestinal tract under spinal anesthesia may not be rational, and that EOF may facilitate recovery of bowel function.