Effectiveness of early postoperative oral hydration after colorectal surgery with general anesthesia: A prospective randomized controlled trial

Abstract

BACKGROUND: Over the last decades, studies have already demonstrated that early feeding in patients after elective colorectal surgery yielded a shorter length of hospital stay and did not cause additional risk for adverse events. However, the optimal timing for beginning oral hydration after colorectal surgery under general anesthesia remains controversial. Therefore, we conducted the study to evaluate the effects of early oral hydration (EOH) versus traditional oral hydration (TOH) on thirst and clinical safety outcomes after colorectal surgery under general anesthesia. METHODS: This prospective randomized controlled trial of 1,000 patients with American Society of Anesthesiologists I–III who underwent colorectal surgery under general anesthesia were randomly assigned to the EOH group (given 0.5 ml/kg water after recovery from general anesthesia) or TOH group (fasting and water deprivation until postoperative intestine function recovery). The primary outcome was thirst scale, and secondary outcomes were discomfort score, nausea and vomiting score, and safety outcomes. RESULTS: Of the 1,000 patients who underwent randomization at initial stage, 27 were excluded in EOH group because of refusal (n=22) or nausea and vomiting before hydration (n=5). Demographic and operative data were similar, but not statistically significant (P>0.05). Patients who received EOH were associated with lower thirst score than with TOH (EOH 45.70±24.51 vs. TOH 62.20±23.99; P<0.001) and oropharyngeal discomfort scale (EOH 3.71±8.49 vs. TOH 6.18±11.89, P<0.0001) 30 min after drinking. No significant differences were found for the time of intestinal movements (EOH 73.37±34.49 h, TOH 70.56±31.71, P=0.187) and for EOH and TOH for the risk of nausea and vomiting at the postoperative period (P>0.05) and other complications (P>0.05). CONCLUSIONS: The findings suggested the safety outcomes for mild EOH on patients after colorectal surgery under general anesthesia. Patients who received EOH could have significantly reduced degree of thirst scale and oropharyngeal discomfort scale 30 min after drinking. Trial registration: CHiCTR, CHiCTR-TRC-13003097. Registered 11 March2013, http://www.chictr.org.cn/showproj.aspx?proj=6462.

Abdominal Cerrahi Sonrasında Bağırsak Fonksiyonlarını Artırmada Farmakolojik Olmayan Yöntemlerin Kullanımı: Kanıtlar Ne Diyor?

“…Ameliyat sonrası erken oral hidrasyon gastrointestinal sistem üzerine olumlu etkilerinin olması nedeniyle önerilmektedir 18,19 20 . Tayland'da yapılan bir araştırmada jinekolojik cerrahi geçiren kadın hastaların ameliyat sonrası sabah erken mobilizasyonu sağlanarak bir gruba (n=45) 120 ml ılık su, diğer gruba (n=45) ise aynı miktarda çay (Cassia alata Linn)…”