Patient tolerance of the early introduction of oral fluids after laparotomy

Early introduction of oral fluids after laparotomy permits effective hydration and earlier introduction of diet. Whether patients find such regimens difficult to tolerate has not been properly studied. A series of 60 consecutive patients undergoing abdominal surgery were randomised to receive oral fluids ad libitum from the first postoperative day (group 1) or in the traditional graduated regimen of 30 ml/h for 24 h, 60 ml/h for 24 h, 90 ml/h for 24 h and then free fluids (group 2). Patients were assessed daily with regard to objective and subjective criteria of hydration and nausea as well as noting time to bowel activity and days of first meal and discharge. Both groups had similar changes in serum urea, haematocrit and urine specific gravity; frequency of vomiting and antiemetic usage were also comparable. Patients in group 1 drank more (P < 0.001), however, and consequently felt less dehydrated. Discontinuation of intravenous fluids and ingestion of the first meal were also achieved 24 h earlier in this group.