Impact of early postoperative oral hydration in paediatric patients undergoing elective surgery after general anaesthesia. A randomised controlled trial.

Abstract

Background and aims: Early feeding or oral hydration post-surgery in paediatric patients has conventionally not been encouraged, with fasting periods ranging from 3 to 6 h. The primary objective of this study was to compare the Face, Legs, Activity, Cry, Consolability (FLACC) score as a surrogate for patient satisfaction in younger children between those who received early versus delayed postoperative feeding/hydration. Secondary objectives were to compare the incidence of complications, perioperative clinical parameters and parental satisfaction.

Methods: A single-blind, randomised trial was conducted in children of both genders, aged 1-5 years, undergoing elective surgery. Children were randomly allocated using sealed envelopes to receive either early hydration (EH) within 30 min of arrival to the post-anaesthesia care unit (PACU) or delayed standard hydration (SH) after 2 h. A rescue dose of fentanyl was given if the FLACC score was ≥6 at any time in PACU. The primary outcome was the FLACC score in PACU after 1 h. Statistical tests used were the unpaired t-test for normally distributed data, Mann-Whitney U test for non-normally distributed data and Fisher's exact test for categorical variables. P < 0.05 was considered significant.

Results: Out of the initially randomised 66 patients, 61 were finally analysed. Demographic and perioperative parameters were similar in both groups. FLACC score after 1 h in PACU was significantly lower in Group EH [1 (0.25-2)] than in Group SH [2 (1-3)] (P = 0.028). Parental satisfaction was higher in Group EH. There were no major complications.

Conclusion: Early postoperative oral hydration is efficacious and safe compared to standard delayed feeds in children undergoing elective surgery.