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Early Postoperative Oral Hydration in Pediatric Ambulatory Surgery: How Much and When?
Feyza Sever 1, Nazmiye Çelik 2, Kahir Güneş 3, Süleyman Arif Bostancı 4, Selman Kürşat Balcı 4, Emrah Şenel 4
1 Ankara Bilkent City Hospital Department of Anesthesiology, Ankara
2 Ankara Bilkent City Hospital, Department of Pediatric Surgery Intensive Care, Ankara
3 Polatlı Duatepe State Hospital, Department of Anesthesiology, Ankara
4 Ankara Bilkent City Hospital Department of Pediatric Surgery, Ankara
Purpose:
Prolonged fasting and dehydration in the postoperative period may threaten patient safety and contribute to agitation and crying in children. Evidence suggests that delayed oral intake adversely affects outcomes, yet clear guidance on timing and volume of postoperative oral hydration remains lacking. This study aimed to determine the safe timing and volume of oral fluid intake in healthy children aged 1–8 years undergoing ambulatory surgery and to present preliminary results.
Method:
A total of 61 children aged 1–8 years scheduled for elective ambulatory surgery were randomly assigned into two groups. In the early fluid group (EG), children received up to 10 ml/kg of room-temperature clear fluid 1 hour after recovery from anesthesia. In the control group (CG), children were allowed to consume room-temperature clear fluids as tolerated, starting 2 hours after recovery. Vomiting was monitored every 30 minutes from 10 minutes after fluid intake until discharge. Additionally, delayed vomiting incidence was assessed through follow-up phone calls on postoperative days 1 and 3. Data were collected using a patient information form and a standardized 4-point postoperative vomiting (POV) scale.
Results:
Data from all 61 patients were analyzed. The mean clear fluid intake was 8.75 ml/kg in the EG and 11.5 ml/kg in the CG, with a statistically significant difference between groups (p = 0.007). The incidence of immediate postoperative vomiting was 6.6% in the EFG and 6.4% in the CG (p = 1.000), with no statistically significant difference. The mean discharge time was significantly shorter in the EG (203.2 minutes) compared to the CG (236 minutes) (p = 0.012).
Conclusion:
Administering a tolerable volume of clear fluids 1 hour postoperatively does not increase early vomiting in children undergoing elective ambulatory surgery. Early oral hydration appears safe and may facilitate earlier discharge.