When Kids Allowed to Eat, Postoperative PONV Decreases

A study presented at this year’s ASA Annual Meeting offers evidence that a liberal drinking and eating policy for children after surgery improves recovery and does not increase the incidence of one of the most universally dreaded surgical side effects of anesthesia: postoperative nausea and vomiting (PONV).

Previous studies have demonstrated increased incidence of PONV when oral intake was mandated after surgery. But Christian C. Apfel, M.D., and his group from the University of California-San Francisco found a different pattern.

“We all know from our clinical experience that vomiting can be triggered by oral intake,” said Dr. Apfel. “And studies that mandated keeping oral intake for discharge have shown an increase of PONV in the postanesthesia care unit. Thus we expected that delaying oral intake might merely delay the time until PONV was triggered, but not the overall incidence. Interestingly, it didn’t increase the incidence at all at any time. This is a new finding that has not been studied before.”

According to Dr. Apfel, PONV is consistently rated as among the most unpleasant experiences after anesthesia, and it can delay recovery, impair quality of life, and endanger surgical success and eventually incur significant health care costs.

Dr. Apfel also stated that liberal oral intake postoperatively may even favorably influence the perception of pain in children.

“All subjective symptoms correlate,” said Dr. Apfel. “And so being less hungry means being in a better mood and thus being less affected by or being better able to cope with pain.”

Dr. Apfel feels that his study will affect the treatment procedures of this common and confounding post-anesthetic experience.

“We believe that our study could have a major impact on the practice of anesthesia worldwide,” he said. “We knew that mandating postoperative intake isn’t good, but now we also know that withholding it doesn’t make sense either.”

Anesthesiologists: Physicians providing the lifeline of modern medicine. Founded in 1905, the American Society of Anesthesiologists is an educational, research and scientific association with 43,000 members organized to raise and maintain the standards of the medical practice of anesthesiology and improve the care of the patient.

Source: American Society of Anesthesiologists (ASA)