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The effect of postoperative fasting on vomiting in children and their assessment of pain.

Author(s): Radke OC, Biedler A, Kolodzie K, Cakmakkaya OS, Silomon M, Apfel CC

Affiliation(s): Perioperative Clinical Research Core, Department of Anesthesia and Perioperative Care, University of California at San Francisco, UCSF Medical Center at Mount Zion, San Francisco, CA 94115, USA.

Publication date & source: 2009-05, Paediatr Anaesth., 19(5):494-9.

Publication type: Randomized Controlled Trial; Research Support, Non-U.S. Gov't

BACKGROUND: Mandatory postoperative food intake has been shown to increase nausea and vomiting, and so postoperative fasting has become common practice even if patients request food or drink. OBJECTIVE: We sought to investigate whether postoperative fasting reduces the incidence of postoperative vomiting in children when compared with a liberal regimen in which they are allowed to eat and drink upon request. METHODS: One hundred forty-seven children scheduled for outpatient surgery were randomized to one of two groups. After anesthesia, patients in the 'fasting' group were expected to fast for 6 h. The children in the 'liberal' group were allowed to eat and drink according to their own needs. The incidence of vomiting and the children's well-being were recorded at several time points over a 24-hour period. Parents were also asked to rate, on a scale of 0-6, how much their children were bothered by fasting, pain, and nausea/vomiting. RESULTS: Age (4.8 +/- 2.6 years), weight (20 +/- 9 kg) and gender (73% boys) were comparable between the groups. The incidence of vomiting was 15% in the liberal and 22% in the fasting group (P = 0.39) and, between 1 and 12 h after extubation, children in the liberal group were significantly happier (P < 0.001). Children in the liberal group were significantly less bothered by their pain than those in the fasting group (P < 0.001). CONCLUSION: Postoperative fasting did not reduce the incidence of vomiting after general anesthesia in children when compared with a liberal regimen. Furthermore, the ability to eat and drink at will decrease the bothersome aspects of pain and lead to happier patients.

Page last updated: 2009-10-20

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