The effect of preoperative fasting on postoperative thirst, hunger and oral intake in paediatric ambulatory tonsillectomy

Authors

  • Seija Klemetti,

    1. Authors: Seija Klemetti, MNSc, PhD (c), RN, Department of Nursing Science, University of Turku, and Department of Otorhinolaryngology – Head and Neck Surgery, University Hospital of Turku; Ilpo Kinnunen, PhD, MD, Consultant Otolaryngologist – Head and Neck Surgeon, Department of Otorhinolaryngology – Head and Neck Surgery, University Hospital of Turku; Tarja Suominen, PhD, RN, Adjunct Professor, Department of Nursing Science, University of Turku, Turku and Professor, Department of Nursing Science, University of Tampere, Tampere; Heikki Antila, PhD, MD, Consultant Anaesthesiologist, Department of Anaesthesiology, University Hospital of Turku, Intensive Care, Emergency Care and Pain Therapy; Tero Vahlberg, MSc, Biostatistician, Department of Biostatistics, University of Turku; Reidar Grenman, PhD, MD, Professor, Department of Otorhinolaryngology – Head and Neck Surgery, University Hospital of Turku; Helena Leino-Kilpi, PhD, RN, Professor, Department of Nursing Science and South-Western Hospital District, University of Turku, Turku, Finland
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  • Ilpo Kinnunen,

    1. Authors: Seija Klemetti, MNSc, PhD (c), RN, Department of Nursing Science, University of Turku, and Department of Otorhinolaryngology – Head and Neck Surgery, University Hospital of Turku; Ilpo Kinnunen, PhD, MD, Consultant Otolaryngologist – Head and Neck Surgeon, Department of Otorhinolaryngology – Head and Neck Surgery, University Hospital of Turku; Tarja Suominen, PhD, RN, Adjunct Professor, Department of Nursing Science, University of Turku, Turku and Professor, Department of Nursing Science, University of Tampere, Tampere; Heikki Antila, PhD, MD, Consultant Anaesthesiologist, Department of Anaesthesiology, University Hospital of Turku, Intensive Care, Emergency Care and Pain Therapy; Tero Vahlberg, MSc, Biostatistician, Department of Biostatistics, University of Turku; Reidar Grenman, PhD, MD, Professor, Department of Otorhinolaryngology – Head and Neck Surgery, University Hospital of Turku; Helena Leino-Kilpi, PhD, RN, Professor, Department of Nursing Science and South-Western Hospital District, University of Turku, Turku, Finland
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  • Tarja Suominen,

    1. Authors: Seija Klemetti, MNSc, PhD (c), RN, Department of Nursing Science, University of Turku, and Department of Otorhinolaryngology – Head and Neck Surgery, University Hospital of Turku; Ilpo Kinnunen, PhD, MD, Consultant Otolaryngologist – Head and Neck Surgeon, Department of Otorhinolaryngology – Head and Neck Surgery, University Hospital of Turku; Tarja Suominen, PhD, RN, Adjunct Professor, Department of Nursing Science, University of Turku, Turku and Professor, Department of Nursing Science, University of Tampere, Tampere; Heikki Antila, PhD, MD, Consultant Anaesthesiologist, Department of Anaesthesiology, University Hospital of Turku, Intensive Care, Emergency Care and Pain Therapy; Tero Vahlberg, MSc, Biostatistician, Department of Biostatistics, University of Turku; Reidar Grenman, PhD, MD, Professor, Department of Otorhinolaryngology – Head and Neck Surgery, University Hospital of Turku; Helena Leino-Kilpi, PhD, RN, Professor, Department of Nursing Science and South-Western Hospital District, University of Turku, Turku, Finland
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  • Heikki Antila,

    1. Authors: Seija Klemetti, MNSc, PhD (c), RN, Department of Nursing Science, University of Turku, and Department of Otorhinolaryngology – Head and Neck Surgery, University Hospital of Turku; Ilpo Kinnunen, PhD, MD, Consultant Otolaryngologist – Head and Neck Surgeon, Department of Otorhinolaryngology – Head and Neck Surgery, University Hospital of Turku; Tarja Suominen, PhD, RN, Adjunct Professor, Department of Nursing Science, University of Turku, Turku and Professor, Department of Nursing Science, University of Tampere, Tampere; Heikki Antila, PhD, MD, Consultant Anaesthesiologist, Department of Anaesthesiology, University Hospital of Turku, Intensive Care, Emergency Care and Pain Therapy; Tero Vahlberg, MSc, Biostatistician, Department of Biostatistics, University of Turku; Reidar Grenman, PhD, MD, Professor, Department of Otorhinolaryngology – Head and Neck Surgery, University Hospital of Turku; Helena Leino-Kilpi, PhD, RN, Professor, Department of Nursing Science and South-Western Hospital District, University of Turku, Turku, Finland
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  • Tero Vahlberg,

    1. Authors: Seija Klemetti, MNSc, PhD (c), RN, Department of Nursing Science, University of Turku, and Department of Otorhinolaryngology – Head and Neck Surgery, University Hospital of Turku; Ilpo Kinnunen, PhD, MD, Consultant Otolaryngologist – Head and Neck Surgeon, Department of Otorhinolaryngology – Head and Neck Surgery, University Hospital of Turku; Tarja Suominen, PhD, RN, Adjunct Professor, Department of Nursing Science, University of Turku, Turku and Professor, Department of Nursing Science, University of Tampere, Tampere; Heikki Antila, PhD, MD, Consultant Anaesthesiologist, Department of Anaesthesiology, University Hospital of Turku, Intensive Care, Emergency Care and Pain Therapy; Tero Vahlberg, MSc, Biostatistician, Department of Biostatistics, University of Turku; Reidar Grenman, PhD, MD, Professor, Department of Otorhinolaryngology – Head and Neck Surgery, University Hospital of Turku; Helena Leino-Kilpi, PhD, RN, Professor, Department of Nursing Science and South-Western Hospital District, University of Turku, Turku, Finland
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  • Reidar Grenman,

    1. Authors: Seija Klemetti, MNSc, PhD (c), RN, Department of Nursing Science, University of Turku, and Department of Otorhinolaryngology – Head and Neck Surgery, University Hospital of Turku; Ilpo Kinnunen, PhD, MD, Consultant Otolaryngologist – Head and Neck Surgeon, Department of Otorhinolaryngology – Head and Neck Surgery, University Hospital of Turku; Tarja Suominen, PhD, RN, Adjunct Professor, Department of Nursing Science, University of Turku, Turku and Professor, Department of Nursing Science, University of Tampere, Tampere; Heikki Antila, PhD, MD, Consultant Anaesthesiologist, Department of Anaesthesiology, University Hospital of Turku, Intensive Care, Emergency Care and Pain Therapy; Tero Vahlberg, MSc, Biostatistician, Department of Biostatistics, University of Turku; Reidar Grenman, PhD, MD, Professor, Department of Otorhinolaryngology – Head and Neck Surgery, University Hospital of Turku; Helena Leino-Kilpi, PhD, RN, Professor, Department of Nursing Science and South-Western Hospital District, University of Turku, Turku, Finland
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  • Helena Leino-Kilpi

    1. Authors: Seija Klemetti, MNSc, PhD (c), RN, Department of Nursing Science, University of Turku, and Department of Otorhinolaryngology – Head and Neck Surgery, University Hospital of Turku; Ilpo Kinnunen, PhD, MD, Consultant Otolaryngologist – Head and Neck Surgeon, Department of Otorhinolaryngology – Head and Neck Surgery, University Hospital of Turku; Tarja Suominen, PhD, RN, Adjunct Professor, Department of Nursing Science, University of Turku, Turku and Professor, Department of Nursing Science, University of Tampere, Tampere; Heikki Antila, PhD, MD, Consultant Anaesthesiologist, Department of Anaesthesiology, University Hospital of Turku, Intensive Care, Emergency Care and Pain Therapy; Tero Vahlberg, MSc, Biostatistician, Department of Biostatistics, University of Turku; Reidar Grenman, PhD, MD, Professor, Department of Otorhinolaryngology – Head and Neck Surgery, University Hospital of Turku; Helena Leino-Kilpi, PhD, RN, Professor, Department of Nursing Science and South-Western Hospital District, University of Turku, Turku, Finland
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Seija Klemetti, Department of Otorhinolaryngology – Head and Neck Surgery, University Hospital of Turku, Box 52, 20521 Turku, Finland. Telephone: +358 2 313 1556.
E-mail:seija.klemetti@utu.fi

Abstract

Aims and objectives.  The aim of this prospective study was to examine whether preoperative face-to-face counselling about a child’s fasting and active preoperative nutrition have an effect on thirst, hunger and postoperative oral intake in paediatric ambulatory tonsillectomy. Families, whose child was admitted for ambulatory tonsillectomy, participated in the study (n = 116; 58/58).

Background.  Children undergoing tonsillectomy have difficulties in postoperative recovery and nutrition. However, former studies have shown that shorter preoperative fasting seems to promote postoperative well-being and promote the child’s postoperative oral intake.

Design.  A prospective, randomised intervention study.

Methods.  The study groups were randomly allocated. The intervention group received the instructions through face-to-face counselling about the child’s active preoperative nutrition, the control group received the instructions according to the current practice. The postoperative thirst and hunger were scored during the first postoperative hour and at two, four, eight and 24 hours postoperatively. The first scoring was performed by the nurse on a 0–10 scale. The rest of the estimations were made by the children using a visual analogue scale (VAS), by the parents using a 0–10 scale.

Results.  In the intervention group, the VAS scores in thirst and hunger were low during the first 24 postoperative hours, whereas in the control group, they increased towards the following morning when the children in the control group, according to the children and the parents, were thirstier (p = 0·051, 0·005, respectively) and significantly hungrier (p = 0·042, 0·005) than those in the intervention group.

Conclusions.  Children’s perioperative fluid fasting can be decreased with preoperative nutritional face-to-face counselling. Children’s perioperative thirst and hunger can be relieved by the limited preoperative fasting.

Relevance to clinical practice.  Clinical practice should take the child’s perioperative fasting into account in a more accurate way in preoperative counselling of the parents.

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