Effect of Oral 12% Carbohydrate Containing
Clear Fluid in Children on Post-anaesthesia
Recovery Profile- A Randomised Clinical Trial
UC01-UC04
Correspondence
Dr. Archana Anilkumar Bharadwaj,
Plot No. 4, Shakambari, 2nd Main, 2nd Cross, Vidyagiri,
Dharwad-580004, Karnataka, India.
E-mail: archana.a.b16@gmail.com
Introduction: The perioperative fast is an unpleasant experience, especially for children, as prolonged fasting leads to dehydration, hunger and anxiety. American Society of Anaesthesiology (ASA) recommends the 6-4-2 regimen for preoperative fasting. Preoperative carbohydrate containing clear fluids have been included in the Enhanced Recovery After Surgery (ERAS) protocol due to benefits in adult surgical patients, but very little has been studied about postanaesthesia recovery, especially in children.
Aim: To study the effect of oral 12% clear carbohydrate fluid on postanaesthesia recovery profile in children.
Materials and Methods: The randomised clincial trial was done on 101 children belonging to ASA physical status I and II, aged 2 to 8 years, scheduled for elective procedures, who were randomly allocated to two groups. The study children received 5 mL/Kg of body weight of clear apple juice two hours prior to anaesthetic induction, and those in the control group were advised to follow the standard 6-4-2 fasting regimen (solid, breast milk, clear fluid). A Random Blood Sugar (RBS) value was measured intraoperatively. The time taken to achieve a Modified Aldrete Score (MAS) of >9 was noted from the time of extubation. The time taken for the children to ask for oral intake and the time taken to attain the recommended discharge criteria were noted in the recovery room. Independent t-test and Mann-Whitney U-test were applied for comparing the various parameters assessed, with a significance level of α=0.05.
Results: Mean age of the population in the study group and the control group were 4.520±1.9 years and 4.775±2.02 years (p-value=0.548), respectively. It was found that the children in the study group took a longer time to attain MAS of >9 (study group 18.70±10.19 minutes and control group 16.86±6.85 minutes, p-value=0.007) and had lower intraoperative blood sugar levels compared to the control group {the median (IQR) values of study group 70 (60-79) mg/dL and control group 90 (85-98) mg/dL, p-value=0.005}. Time to ask for oral intake was longer in the study group indicating decreased thirst (study group 49.40±31.08 (minutes) and control group 25.88±16.93 (minutes), p-value=0.0001). None of the children had complications like vomiting or pulmonary aspiration in the perioperative period.
Conclusion:Oral clear 12% carbohydrate fluid as part of preoperative fasting regime is safe for post-anaesthesia recovery