Abstract
BackgroundThe feasibility and safety of administrating a small amount of oral fluid to children in the early recovery period following tonsillectomy under general anesthesia to reduce the thirst and its associated restlessness remain unknown.MethodsThis study was approved by the institutional ethics committee and adhered to the CONSORT guidelines. Pediatric patients undergoing tonsillectomy who met the inclusion and exclusion criteria of our study were randomized into the study and control groups. In the study group, patients were given a small amount of water instantly after recovering from general anesthesia, which included the recovery of the cough and deglutition reflex, and attaining grade V of muscle strength. The control group was given a small amount of water at 4 to 6 h after the operation. The incidence of nausea and vomiting and the degree of thirst relief were measured and compared between the two groups.ResultsThree hundred patients were randomized into each group. There was no significant difference in the incidence of nausea and vomiting at 20 min after drinking water between the two groups (P > 0.05). The thirst score of children over 5 years old in the study group was significantly lower than that of the control group (P < 0.05).ConclusionEarly administration of a small amount of oral fluid to children following tonsillectomy and recovering from general anesthesia is not only safe but also effective in reducing postoperative thirst.Trial registrationCurrent Controlled Trials ChiCTR1800020058, 12-12-2018.
Highlights
The feasibility and safety of administrating a small amount of oral fluid to children in the early recovery period following tonsillectomy under general anesthesia to reduce the thirst and its associated restlessness remain unknown
Our previous studies [6, 7] showed that patients routinely fasted for more than 15 h before surgery, and more than 81% of the children returned to the PostAnesthesia Care Unit (PACU) after surgery were thirsty and wanted to have oral fluid
The recovery period following general anesthesia is a period for children to fully regain their important physiological functions but is a period associated with a high risk of adverse events as a result of restlessness [12, 13], which is not uncommon in children and adolescents during the recovery period following general anesthesia, especially among male children [14]
Summary
The feasibility and safety of administrating a small amount of oral fluid to children in the early recovery period following tonsillectomy under general anesthesia to reduce the thirst and its associated restlessness remain unknown. Our previous studies [5,6,7] reported that earlier than 2 h in the postoperative period, even within 20 min of waking from anesthesia, oral hydration did not increase the occurrence of postoperative nausea and vomiting or inhibit gastric peristalsis in the children and adult patients undergoing non-gastrointestinal surgery except tonsillectomy under general anesthesia, which is safe and well tolerated. Thirst is common in children undergoing tonsillectomy and often causes severe agitation in the recovery period following anesthesia, leading to increased oxygen consumption, arrhythmia, wound bleeding, etc. Patients may inadvertently pull out the infusion tube, urinary catheter, and other medical equipment, which will adversely affect the postoperative recovery [15]
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