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Supplemental intraoperative crystalloids for pediatric postoperative nausea and vomiting-A systematic review and

Sunaakshi Puri1, Anjishnujit Bandyopadhyay1, Vighnesh Ashok1

  • 1Department of Anaesthesia and Intensive Care, Post Graduate Institute of Medical Education and Research, Chandigarh, India.

Paediatric Anaesthesia
|September 30, 2022
PubMed

Insights

Supplemental intraoperative intravenous crystalloids significantly reduce postoperative nausea and vomiting (PONV) and thirst in pediatric patients. This fluid therapy also decreases the need for anti-emetic rescue medications in children undergoing surgery.

Area of Science:

  • Anesthesiology
  • Pediatric Surgery
  • Pharmacology

Background:

  • Postoperative nausea and/or vomiting (PONV) is common in pediatric patients after general anesthesia.
  • Perioperative fluid administration may impact PONV incidence in adults.
  • The efficacy of supplemental intraoperative fluids for pediatric PONV is under investigation.

Approach:

  • Systematic review and meta-analysis of randomized controlled trials (RCTs) up to March 2022.
  • Included pediatric patients (≤18 years) undergoing elective surgery under general anesthesia.
  • Compared conventional vs. supplemental intraoperative intravenous crystalloid therapy.

Key Points:

  • Seven RCTs involving 864 patients were analyzed.
  • Supplemental crystalloids reduced postoperative vomiting (RR 0.56) and PONV (RR 0.52).
  • Reduced postoperative thirst (RR 0.21) and need for rescue anti-emetics (RR 0.60) were observed.

Conclusions:

  • Intraoperative intravenous crystalloids effectively reduce PONV outcomes in pediatric patients.
  • This intervention also alleviates postoperative thirst and reduces anti-emetic requirements.
  • Findings apply to healthy children undergoing superficial surgeries with volatile anesthetic agents.
Abstract

Keywords:
Supplemental fluidsanesthesiapediatric surgerypostoperative nausea and vomitingrecovery

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