The Effects of Early Oral Intake in the Postanesthesia Care Unit on Nausea and Vomiting: A Meta-analysis of Randomized Controlled Trials.

Abstract

Purpose: This systematic review and meta-analysis aimed to investigate whether early oral fluid intake after surgery compared with delayed oral intake causes nausea and vomiting in pediatric patients who underwent general anesthesia in the postanesthesia care unit (PACU).

Design: Systematic review and meta-analysis.

Methods: Conducted in accordance with the Cochrane Handbook for Systematic Reviews of Interventions (version 6.4), this study searched electronic databases, including Pubmed, CINAHL, Embase, Cochrane CENTRAL, PubMed, RISS, and KoreaMed up to July 2023. The Risk of Bias 2 tool assessed the risk of bias, and R statistical software facilitated meta-analysis. The certainty of evidence was evaluated using the Grading of Recommendations, Assessment, Development, and Evaluation approach.

Findings: A meta-analysis of 6 randomized controlled trials (RCTs) (2,723 patients) found early oral intake in the PACU decreased vomiting incidence by 36% compared with delayed oral fluid intake (risk ratio = 0.64, 95% confidence interval: 0.42 to 0.97, P = .040, I² = 7%) with moderate certainty of evidence. Another meta-analysis of 3 RCTs (2,185 participants) showed that early oral intake did not increase nausea compared with delayed oral intake (95% confidence interval: -0.76 to 0.07, P = .071, I² = 0%) with low certainty of evidence.

Conclusions: Early oral fluid intake in the PACU decreases postoperative vomiting without raising nausea. Health care providers should consider implementing early oral fluid intake in the PACU for enhanced recovery of pediatric patients.