Abstract No.: ABS1042: A Randomised Controlled Trial To Compare The Occurrence Of Postoperative Nausea And Vomiting In Early Versus Conventional Feeding In Children Undergoing Day Care Surgery Under General Anaesthesia

Abstract

Background & Aims:Practice of postoperative fasting of 4-6 hours in children has no specific evidence. We planned this study to assess postoperative nausea vomiting (PONV) with early oral feeding as compared to conventional feeding in children undergoing day care surgery under general anaesthesia (GA)Methods:This was a randomised controlled trial, conducted after approval by Institutional Ethical Committee, registered in Clinical TrialsRegistry of India (CTRI No - CTRI/2020/01/022789). Three hundred children were randomised into group of early feeding (EF, n=150) or conventional feeding (CF, n=150). Standardised general anaesthesia was induced. Postoperatively, group EF received carbohydrate feed on demand, group CF received feed after 4-6 hours. Maximum feed given was 10 ml/kg body weight. Time, volume of first postoperative feed, incidence of PONV, postoperative pain [by Face,Legs,Activity,Cry,Consolability (FLACC Score)after the first feed, complications and parents satisfaction were recorded.Results:Time to first postoperative feed was 64.87 minutes in group EF and 273.28 minutes in group CF (p < 0.001). Incidence of PONV was comparable (EF vs CF = 12% vs 18.7%, p = 0.109). Difference in mean FLACC score were significant at 0 minutes, 30 minutes and 1 hour (p <0.001). Group EF had significantly shorter hospital stay (7.31 vs 11.13 hours, p =<0.001) and significantly better parental satisfaction score (p <0.001Table 1Demographic ProfilePatient characteristicsMean±SDP* Group EF (n=150)Group CF (n=150)Age (years)6.46±2.486.58±2.640.794aWeight (kg)19.79±6.9619.90±6.470.635aGender Male102 (68%)48 (32%)0.149b Female90 (60%)60 (40%)Conclusion:Early postoperative feeding in children is safe and does not increase the incidence of PONV as compared to conventionalfeeding and is associated with shorter duration of hospital stay and improved parental satisfaction.Table 2Postoperative NauseaVomiting (PONV) and FeedsCharacteristicsGroup EF (n=150)Group CF (n=150)P*Incidence of PONV18 (12%)28 (18.7%)0.109aVolume of Feed (ml)22.45±9.0423.21±6.740.080bType of Feed 5% Dextrose40 (26.7%)40 (26.7%)0.999a Orange juice39 (26.0%)39 (26.0%) Apple juice37 (24.7%)38 (25.3%) Mango drink34 (22.7%)33 (22.0%)Time to 1st Feed (mins)64.87±44.24273.28±34.87<0.001bEpisodes of PONV 0132 (88.0%)122 (81.3%)0.215c 114 (9.3%)24 (16.0%) 24 (2.7%)4 (2.7%)Vomiting Score0.23±0.660.36±0.800.107bDose of Antiemetics (Ondansetron, mg)0.19±0.550.36±0.810.084baChi-squared test, bWilcoxon-Mann-Whitney U test, cFisher’s Exact test