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Is fasting duration important in post adenotonsillectomy feeding time?
Yalda Jabbari Moghaddam1, Mahin Seyedhejazi2, Mosoud Naderpour1
1Department of Otolaryngology, Head and Neck Surgery, Tabriz University of Medical Sciences, Tabriz, Iran.
Insights
Shortening pre-adenotonsillectomy fasting and providing oral dextrose improved pain control and oral feeding initiation in children. However, this protocol did not significantly reduce postoperative nausea or vomiting.
Area of Science:
- Pediatric Otolaryngology
- Anesthesiology
- Surgical Complication Management
Background:
- Adenotonsillectomy is a frequent pediatric surgical procedure.
- Postoperative nausea and vomiting (PONV) are common complications, affecting 49-73% of patients.
Purpose of the Study:
- To assess the impact of a shortened fasting protocol with oral dextrose on postoperative pain, nausea, vomiting, and oral feeding.
- To evaluate the efficacy of pre-adenotonsillectomy hydration in pediatric surgical recovery.
Main Methods:
- A randomized controlled trial involving 120 children (4-14 years) undergoing adenotonsillectomy.
- Intervention group received 10% oral dextrose 3 and 6 hours pre-operatively; control group followed standard fasting.
- Data collected on pain, PONV, and oral feeding initiation; analyzed using SPSS with significance at P < 0.05.
Main Results:
- The intervention group required significantly less acetaminophen and initiated oral feeding sooner (P < 0.005).
- Pain severity was significantly lower in the intervention group post-surgery (P < 0.001).
- Nausea frequency was lower at recovery (P < 0.002), but not significantly different at other times; vomiting frequency showed no significant difference.
Conclusions:
- Shortened pre-adenotonsillectomy fasting and hydration effectively reduce postoperative pain and speed oral feeding initiation.
- This hydration strategy does not appear to prevent postoperative nausea and vomiting following adenotonsillectomy.
Background:
Adenotonsillectomy is a common otolaryngology surgery. Nausea and vomiting are the most common complications of this procedure with a prevalence ranging from 49% to 73 %.
Objectives:
Our aim was to evaluate the effects of short time fasting protocol on decreasing postoperative pain, nausea and vomiting, and initiation of oral feeding after adenotonsillectomy.
Patients And Methods:
120 children aged 4 to 14 years candidates for adenotonsillectomy were randomly divided into intervention and control groups (n = 120, 60 in each group). Each patient of the intervention group was given oral dextrose 10% as much volume as he could consume at 3 and 6 hours prior to the operation. All the data including pain severity, nausea and vomiting of the patients, the time of oral feeding initiation etc. were gathered in checklists after the operation. Statistical analyses were then performed using Statistical Package for the Social Sciences (SPSS) software version 16. Descriptive statistical methods and mean difference test for independent groups and chi square test or Fisher exact test, and if regression needed model test were applied. A P value of 0.05 or less was considered statistically significant.
Results:
The amount of Acetaminophen administered for the intervention group was significantly lower than the control group, and also the time of oral feeding initiation was significantly shorter in the intervention group than the control group (P < 0.005). Pain severity at all occasions following surgery was significantly lower in the intervention group than the control group (P < 0.001). Although frequency of nausea at recovery time was significantly lower in the intervention group than the control group (P < 0.002), there were no significant differences in frequency of nausea between the two groups at other postoperative occasions. Postoperative vomiting frequency was not significant between the two groups at any occasions.
Conclusions:
The findings of this survey showed that shortening the duration of pre-adenotonsillectomy fasting period and hydration of patients several hours prior to the operation might be effective in decreasing postoperative pain and facilitating postoperative oral feeding initiation. Nevertheless this method does not seem to prevent postoperative nausea and vomiting.
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