PDF(Pubmed)
Abstract：
Background/Objectives: Preoperative fasting guidelines traditionally aim to reduce pulmonary aspiration risk. However, concerns over the adverse effects of prolonged fasting have led to exploring alternatives. This study aimed to investigate the impact of preoperative clear liquid intake on postoperative outcomes in children undergoing minimally invasive repair of pectus excavatum (MIRPE). Methods: A prospective randomized controlled study was conducted on children aged 3-6 years scheduled for elective MIRPE. Patients were randomized into either a routine overnight fasting group (NPO) or a clear liquid group. The incidence and severity of emergence delirium (ED) were assessed using Pediatric Anesthesia Emergence Delirium (PAED) and Watcha scales at recovery room. Postoperative pain scores and opioid requirements were evaluated at intervals of 1-6 h, 6-12 h, and 12-24 h after surgery. Results: Fasting time was 178.6 ± 149.5 min and 608.9 ± 148.4 min in the clear liquid group compared and NPO group, respectively. The incidence of ED, measured by PAED and Watcha scales, was lower in the clear liquid group (PAED score ≥ 12: 55.6% vs. 85.2%, p = 0.037; Watcha score ≥ 3: 51.9% vs. 85.2%, p = 0.019). The highest PAED score recorded in the recovery room was significantly lower in the clear liquid group (11.4 ± 2.8 vs. 14.6 ± 2.8, p < 0.001). Clear liquid group showed significantly lower pain scores at 1-6, 6-12, and 12-24 h postoperatively. Additionally, clear liquid group had lower opioid requirement at 1-6 and 6-12 h postoperatively. Conclusions: Preoperative clear liquid consumption was associated with a lower incidence of ED in pediatric patients undergoing MIRPE.
摘要：
背景/目标：术前禁食指南传统上旨在降低肺吸入风险。然而,对长期禁食的不利影响的担忧导致探索替代方案。本研究旨在探讨术前透明液体摄入对微创漏斗胸修补术（MIRPE）患儿术后预后的影响。方法：对计划进行MIRPE的3-6岁儿童进行前瞻性随机对照研究。患者被随机分为常规过夜禁食组（NPO）或透明液体组。在恢复室使用小儿麻醉出现谵妄（PAED）和Watcha量表评估出现谵妄（ED）的发生率和严重程度。术后疼痛评分和阿片类药物需求以1-6小时的间隔进行评估，6-12小时,手术后12-24小时。结果:清液组与NPO组相比禁食时间分别为178.6±149.5min和608.9±148.4min,分别。ED的发病率，用PAED和Watcha量表测量，透明液体组较低(PAED评分≥12：55.6%vs.85.2%,p=0.037；Watcha评分≥3：51.9%vs.85.2%,p=0.019)。恢复室记录的最高PAED评分在透明液体组中明显较低（11.4±2.8vs.14.6±2.8，p<0.001）。透明液体组在术后1-6、6-12和12-24h的疼痛评分显着降低。此外,透明液体组在术后1-6和6-12h的阿片类药物需求较低。结论：术前饮用透明液体与接受MIRPE的儿科患者的ED发生率较低相关。
