Early postoperative oral fluid intake in paediatric day case surgery influences the need for opioids and postoperative vomiting: A controlled randomized trial

C. Chauvin, A. S. Schalber-Geyer, F. Lefebvre, C. Bopp, G. Carrenard, L. Marcoux, J. F. Mayer, C. Schwaab, G. P. Joshi, P. Diemunsch

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

Background. In children younger than 4 yr, it is difficult to distinguish the cause of postoperative distress, such as thirst, pain, and emergence delirium. This may lead to inappropriate treatment, such as administration of opioids. The aim of this study was to evaluate the influence of early postoperative oral fluid intake on the use of opioid analgesics and the incidence of postoperative vomiting (POV) after paediatric day case surgery. Methods. After ethics committee approval and with parental informed consent, planned day surgery patients aged 6 months to 4 yr were randomized to the liberal group (LG), in which apple juice (10 ml kg1) was offered first if the Face Legs Activity Cry COnsolability (FLACC) score was4 in the PACU, or to the control group (CG), in which children were treated after surgery according to the institutional opioid protocol, and drinking was allowed only upon the return to the ward. Bayesian statistical analysis was used to compare POV incidence and opioid use across groups. Results. Data from 231 patients were analysed. The incidence of POV in the LG and the CG was 11.40 and 23.93%, respectively. An opioid was needed in 14.04% (mean total dose: 0.18mg kg1) and 35.89% (mean total dose: 0.20mg kg1) of the patients in the LG and the CG. The PACU stay was 53.45 and 65.05 min in the LG and the CG, respectively (all differences were statistically significant). Conclusions. In our paediatric outpatient setting, early postoperative oral fluid intake was associated with a reduction in opioid use and POV incidence. These results deserve confirmation in other settings.

Original languageEnglish (US)
Pages (from-to)407-414
Number of pages8
JournalBritish Journal of Anaesthesia
Volume118
Issue number3
DOIs
StatePublished - 2017

Fingerprint

Postoperative Nausea and Vomiting
Ambulatory Surgical Procedures
Opioid Analgesics
Randomized Controlled Trials
Pediatrics
Control Groups
Incidence
Parental Consent
Thirst
Ethics Committees
Bayes Theorem
Malus
Informed Consent
Drinking
Leg
Outpatients
Pain

Keywords

  • Ambulatory
  • Paediatrics
  • Pain
  • Postoperative
  • Postoperative nausea and vomiting
  • Surgery

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine

Cite this

Early postoperative oral fluid intake in paediatric day case surgery influences the need for opioids and postoperative vomiting : A controlled randomized trial. / Chauvin, C.; Schalber-Geyer, A. S.; Lefebvre, F.; Bopp, C.; Carrenard, G.; Marcoux, L.; Mayer, J. F.; Schwaab, C.; Joshi, G. P.; Diemunsch, P.

In: British Journal of Anaesthesia, Vol. 118, No. 3, 2017, p. 407-414.

Research output: Contribution to journalArticle

Chauvin, C, Schalber-Geyer, AS, Lefebvre, F, Bopp, C, Carrenard, G, Marcoux, L, Mayer, JF, Schwaab, C, Joshi, GP & Diemunsch, P 2017, 'Early postoperative oral fluid intake in paediatric day case surgery influences the need for opioids and postoperative vomiting: A controlled randomized trial', British Journal of Anaesthesia, vol. 118, no. 3, pp. 407-414. https://doi.org/10.1093/bja/aew463
Chauvin, C. ; Schalber-Geyer, A. S. ; Lefebvre, F. ; Bopp, C. ; Carrenard, G. ; Marcoux, L. ; Mayer, J. F. ; Schwaab, C. ; Joshi, G. P. ; Diemunsch, P. / Early postoperative oral fluid intake in paediatric day case surgery influences the need for opioids and postoperative vomiting : A controlled randomized trial. In: British Journal of Anaesthesia. 2017 ; Vol. 118, No. 3. pp. 407-414.
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abstract = "Background. In children younger than 4 yr, it is difficult to distinguish the cause of postoperative distress, such as thirst, pain, and emergence delirium. This may lead to inappropriate treatment, such as administration of opioids. The aim of this study was to evaluate the influence of early postoperative oral fluid intake on the use of opioid analgesics and the incidence of postoperative vomiting (POV) after paediatric day case surgery. Methods. After ethics committee approval and with parental informed consent, planned day surgery patients aged 6 months to 4 yr were randomized to the liberal group (LG), in which apple juice (10 ml kg1) was offered first if the Face Legs Activity Cry COnsolability (FLACC) score was4 in the PACU, or to the control group (CG), in which children were treated after surgery according to the institutional opioid protocol, and drinking was allowed only upon the return to the ward. Bayesian statistical analysis was used to compare POV incidence and opioid use across groups. Results. Data from 231 patients were analysed. The incidence of POV in the LG and the CG was 11.40 and 23.93{\%}, respectively. An opioid was needed in 14.04{\%} (mean total dose: 0.18mg kg1) and 35.89{\%} (mean total dose: 0.20mg kg1) of the patients in the LG and the CG. The PACU stay was 53.45 and 65.05 min in the LG and the CG, respectively (all differences were statistically significant). Conclusions. In our paediatric outpatient setting, early postoperative oral fluid intake was associated with a reduction in opioid use and POV incidence. These results deserve confirmation in other settings.",
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T1 - Early postoperative oral fluid intake in paediatric day case surgery influences the need for opioids and postoperative vomiting

T2 - A controlled randomized trial

AU - Chauvin, C.

AU - Schalber-Geyer, A. S.

AU - Lefebvre, F.

AU - Bopp, C.

AU - Carrenard, G.

AU - Marcoux, L.

AU - Mayer, J. F.

AU - Schwaab, C.

AU - Joshi, G. P.

AU - Diemunsch, P.

PY - 2017

Y1 - 2017

N2 - Background. In children younger than 4 yr, it is difficult to distinguish the cause of postoperative distress, such as thirst, pain, and emergence delirium. This may lead to inappropriate treatment, such as administration of opioids. The aim of this study was to evaluate the influence of early postoperative oral fluid intake on the use of opioid analgesics and the incidence of postoperative vomiting (POV) after paediatric day case surgery. Methods. After ethics committee approval and with parental informed consent, planned day surgery patients aged 6 months to 4 yr were randomized to the liberal group (LG), in which apple juice (10 ml kg1) was offered first if the Face Legs Activity Cry COnsolability (FLACC) score was4 in the PACU, or to the control group (CG), in which children were treated after surgery according to the institutional opioid protocol, and drinking was allowed only upon the return to the ward. Bayesian statistical analysis was used to compare POV incidence and opioid use across groups. Results. Data from 231 patients were analysed. The incidence of POV in the LG and the CG was 11.40 and 23.93%, respectively. An opioid was needed in 14.04% (mean total dose: 0.18mg kg1) and 35.89% (mean total dose: 0.20mg kg1) of the patients in the LG and the CG. The PACU stay was 53.45 and 65.05 min in the LG and the CG, respectively (all differences were statistically significant). Conclusions. In our paediatric outpatient setting, early postoperative oral fluid intake was associated with a reduction in opioid use and POV incidence. These results deserve confirmation in other settings.

AB - Background. In children younger than 4 yr, it is difficult to distinguish the cause of postoperative distress, such as thirst, pain, and emergence delirium. This may lead to inappropriate treatment, such as administration of opioids. The aim of this study was to evaluate the influence of early postoperative oral fluid intake on the use of opioid analgesics and the incidence of postoperative vomiting (POV) after paediatric day case surgery. Methods. After ethics committee approval and with parental informed consent, planned day surgery patients aged 6 months to 4 yr were randomized to the liberal group (LG), in which apple juice (10 ml kg1) was offered first if the Face Legs Activity Cry COnsolability (FLACC) score was4 in the PACU, or to the control group (CG), in which children were treated after surgery according to the institutional opioid protocol, and drinking was allowed only upon the return to the ward. Bayesian statistical analysis was used to compare POV incidence and opioid use across groups. Results. Data from 231 patients were analysed. The incidence of POV in the LG and the CG was 11.40 and 23.93%, respectively. An opioid was needed in 14.04% (mean total dose: 0.18mg kg1) and 35.89% (mean total dose: 0.20mg kg1) of the patients in the LG and the CG. The PACU stay was 53.45 and 65.05 min in the LG and the CG, respectively (all differences were statistically significant). Conclusions. In our paediatric outpatient setting, early postoperative oral fluid intake was associated with a reduction in opioid use and POV incidence. These results deserve confirmation in other settings.

KW - Ambulatory

KW - Paediatrics

KW - Pain

KW - Postoperative

KW - Postoperative nausea and vomiting

KW - Surgery

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