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Published on: September 20, 2019
Early versus delayed postoperative oral hydration in children following general anesthesia: a prospective randomized
Xiaorong Yin1, Xiaoqi Zeng1, Ting Wang1
1Department of Anesthesiology, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, Sichuan Province, 610041, People's Republic of China.
Insights
Early oral hydration for children after general anesthesia does not increase complications. Offering water sooner significantly reduces thirst and improves patient satisfaction, enhancing recovery comfort.
Area of Science:
- Anesthesiology
- Pediatric Recovery
- Postoperative Care
Background:
- Traditional postoperative oral hydration protocols for children in China involve a 4-6 hour delay.
- This delay can lead to increased complications like apnea, crying, agitation, and bleeding due to thirst and fear.
- Early oral hydration aims to improve patient comfort and safety during post-anesthesia recovery.
Purpose of the Study:
- To compare the safety and tolerability of early oral hydration (EOH) versus delayed oral hydration (DOH) in children post-general anesthesia.
- To assess the impact of EOH and DOH on patient comfort, including thirst, satisfaction, and oropharyngeal discomfort.
- To provide evidence-based recommendations for optimizing postoperative fluid management in pediatric patients.
Main Methods:
- A prospective, randomized study involving 2000 children (ASA I-III).
- Patients were divided into EOH (n=1000) and DOH (n=1000) groups.
- EOH group received water upon recovery of swallowing reflex; DOH group received water at 4 hours post-anesthesia. Monitoring included vital signs, thirst, satisfaction, nausea, and vomiting.
Main Results:
- No significant difference in hypoxemia, nausea, or vomiting incidence between EOH and DOH groups (P > 0.05).
- The EOH group showed a significantly decreased thirst score compared to the DOH group in children over 5 years old (P < 0.05).
- Data collected from 1770 patients confirmed the safety and improved thirst scores with EOH.
Conclusions:
- Early administration of small amounts of drinking water post-general anesthesia is safe for children.
- EOH does not increase the risk of nausea, vomiting, or hypoxemia.
- Early oral hydration effectively decreases thirst and enhances patient satisfaction, improving overall comfort during recovery.
Background:
Oral hydration has typically not been administered for between 4 and 6 h postoperative for children's safety in China. But children are more likely to suffer from apnea, crying and agitation, wound bleeding, and other complications during the post-anesthesia recovery period because of thirsty and fear. This Prospective, randomized study sought to assess the compare the early and late oral hydration (EOH and DOH, respectively) in children following general anesthesia, with the goal of assessing relative safety and tolerability and thereby improving patient comfort.
Methods:
A total of 2000 children corresponding to the American Society of Anesthesiology (ASA) I-III were randomized into an EOH group (n = 1000) and a DOH group (n = 1000). For the former group, children were administered a small amount of drinking water following recovery of the swallowing reflex, and children's vital signs were monitored for 20 min in a postanesthesia care unit (PACU). DOH group patients received water at 4 h following general anesthesia). All patients underwent monitoring to assess their thirst, satisfaction, oropharyngeal discomfort, nausea, and vomiting.
Results:
Complete data were collected from a total of 1770 patients (EOH = 832, DOH = 938) and was compared via chi-squared and t-tests as appropriate. There was no hypoxemia in either group, nor did the incidence of nausea and vomiting differ between the two groups (P > 0.05). The thirst score of the EOH group was significantly decreased relative to the DOH group in the children over 5 years old after drinking for 10 to 20 min (P < 0.05).
Conclusions:
For children undergoing general anesthesia, a small amount of drinking water in the early stages of recovery will not increase the incidence of nausea, vomiting, or hypoxemia, but will decrease thirst and improve satisfaction. It is important, however, that medical staff carefully monitor the swallowing reflex and vital signs of all children.
Trial Registration:
This study was registered on the Chinese Clinical Trial Registry (ChiCTR-IOR-16008197) (http://www.chictr.org.cn/index.aspx. On April 2, 2016 the first patients was enrolled and on March 31, 2016 the trial was registered).
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