Abstract
Objectives Investigation of whether the duration of fasting
preoperatively has an impact on pain and return to normal function after
tonsillectomy To investigate the impact of the duration of preoperative
fasting on pain and return to normal function after tonsillectomy.
Design Retrospective study with surgeon blinded to the participants
undergoing tonsillectomy with or without adenoidectomy Setting
University teaching hospital, Sydney, Australia Participants A total of
174 children (n=174) ages 4-12 years old between February 2017 to April
2020 were enrolled. The children were randomised to receive instructions
either from the staff at the hospital (n=90) or by the anaesthetist
(n=84) in terms of exact pre-operative fasting. Main Outcome measures
Fasting times, clear liquid caloric intake 2 hours prior to surgery and
Parents Postoperative Pain Measures (PPPM) were documented and analysed.
Secondary measures of analgesia usage, number of postoperative nausea or
vomiting events were also analysed. Results Observed difference were
noted between the instructed fasting period and the actual fasting
period. Significant difference in PPPM scores was noted between the
Hospital group and the juice group (p<0.001). No significant
difference was noted at first to 3rd day (p=0.11) or by the 8th to 10th
postoperative day (p=0.93). There was no difference in oxycodone usage
between the two groups (p=0.52), or in postoperative nausea and vomiting
(p=0.43) Conclusions Significantly lower PPPM scores were noted on day
of surgery in the group that had fasting minimised. The effects appeared
to trend in a positive manner but larger number of cases need to be
performed for results to be of greater significance. Further research is
required into the impact of caloric nutrition to enhance recovery after
tonsillectomy.