Comparative Study Between Nasogastric (Ryle) Feeding and Oral Feeding Post- Cleft Palate Repair

Abstract

Background: feeding after surgical correction of cleft palate is an important topic; the method of feeding usually affects the surgery outcome and stress of operation in infants. However, no consensus on the method of feeding for children with cleft palate either pre-or post-operative correction. Aim of the work: to investigate the effect of nasogastric tube (NGT) feeding compared with oral feeding on children in the first 48 hours after primary cleft palate repair. Patients and methods: The study was carried out at Al-Azhar University Hospital (Pediatric Surgery Unit);Damietta and specialized kids hospital during the period from January 2015 to Jun 2016. It included 36 children presented for primary repair of cleft palate. All were undergoing full history taking, clinical examination and laboratory investigations to prepare them for surgical intervention. Those patients were divided into 2 equal groups, each group had 18 patients.Then, after intervention, they followed up to examine the effect of method of feeding either by (NGT) (group 1) or oral route (group 2) on the outcome of surgery and postoperative analgesia requirements. Results: both groups were comparable asregard to demographic characteristics, amount of intraoperative fluids and required analgesia and for postoperative surgical outcome and complications. However, there was statistically significant decrease of Postoperative morphine, paracetamol and Ibuprofen in NG feeding group when compared to oral feeding group (0.13±0.08, 32.50±15.55, 14.44±8.72 vs 0.23±0.13, 51.66±28.43, and 26.38±14.43 respectively). Also, there was significant decrease of number of pain episodes in NGT feeding group when compared to oral feeding group (3.17±2.03 vs 4.77±2.86). On the other hand, there was statistically significant increase of the amount of postoperative feeding in NGT feeding when compared to oral feeding group (137.22±13.52 vs 59.72±18.74). Finally, the total duration of hospital stay was significantly shortened in NGT feeding group when compared to oral feeding group (47.55±15.33 vs 78.66±18.04 hours).Conclusion: NGT feeding is effective when compared to oral feeding post-palatoplasty as it increases consumption of foods and reduce postoperative analgesia requirements.