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Early postoperative feeding in kids after GA associated with shorter duration of hospital stay, finds research
The guidelines for perioperative care in neonatal intestinal surgery known as the Early Recovery After Surgery recommend initiating early enteral feeds for pediatric patients as soon as possible. However, the specific timing for when pediatric patients should resume oral intake after surgery remains unclear. Recent randomized controlled trial compared the effects of early oral feeding (EF) versus conventional feeding (CF) on postoperative outcomes in children undergoing daycare surgery under general anesthesia. The study included 300 children (150 in each group) and assessed the occurrence of postoperative nausea and vomiting (PONV), postoperative pain, duration of hospital stay, and parental satisfaction.
Comparison of PONV Incidence and Pain Scores
The results showed that the incidence of PONV was similar between the two groups, with 12% in the EF group and 18.7% in the CF group (p=0.109). However, the EF group had significantly lower Face, Legs, Activity, Cry, Consolability (FLACC) pain scores at 0 minutes, 30 minutes, and 1 hour postoperatively compared to the CF group.
Duration of Hospital Stay and Parental Satisfaction
Patients in the EF group had a significantly shorter duration of hospital stay, with a mean of 6.31 hours compared to 10.13 hours in the CF group (p<0.001). Parents of children in the EF group also had significantly better satisfaction scores compared to the CF group (p<0.001). The study concluded that early postoperative feeding in children undergoing lower abdominal, non-gastrointestinal surgery under general anesthesia does not increase the incidence of PONV. Furthermore, early feeding was associated with reduced postoperative pain, shorter hospital stay, and higher parental satisfaction. The authors suggest that early postoperative feeding can be safely implemented in this patient population without increasing the risk of adverse events.
Key Points
Based on the provided research paper, the 6 key points are:
1. The study was a randomized controlled trial that compared the effects of early oral feeding (EF) versus conventional feeding (CF) on postoperative outcomes in children undergoing daycare surgery under general anesthesia.
2. The study assessed the occurrence of postoperative nausea and vomiting (PONV), postoperative pain, duration of hospital stay, and parental satisfaction.
3. The incidence of PONV was similar between the EF and CF groups, with 12% in the EF group and 18.7% in the CF group.
4. The EF group had significantly lower Face, Legs, Activity, Cry, Consolability (FLACC) pain scores at 0 minutes, 30 minutes, and 1 hour postoperatively compared to the CF group.
5. Patients in the EF group had a significantly shorter duration of hospital stay, with a mean of 6.31 hours compared to 10.13 hours in the CF group.
6. Parents of children in the EF group had significantly better satisfaction scores compared to the CF group.
Reference –
Singh R, Huligeri HS, Singh P. A randomized controlled trial to compare the occurrence of postoperative nausea and vomiting in early versus conventional feeding in children undergoing daycare surgery under general anaesthesia. Indian J Anaesth 2024;68:815‑20
MBBS, MD (Anaesthesiology), FNB (Cardiac Anaesthesiology)
Dr Monish Raut is a practicing Cardiac Anesthesiologist. He completed his MBBS at Government Medical College, Nagpur, and pursued his MD in Anesthesiology at BJ Medical College, Pune. Further specializing in Cardiac Anesthesiology, Dr Raut earned his FNB in Cardiac Anesthesiology from Sir Ganga Ram Hospital, Delhi.