The role of oral fluid intake following adeno-tonsillectomy

Objective: To compare the incidence of complications following pediatric adenotonsillectomy (T&A) in patients who are encouraged to drink oral liquid versus patients who drink on a voluntary basis. Methods: This is a prospective, randomized, non-blinded study performed in a tertiary care medical center. Ninety-three otherwise healthy pediatric patients aged 2-12 years undergoing ambulatory T&A by a single surgeon were included in the study. Forty four patients were encouraged to drink 240 ml of clear liquid prior to discharge while 49 patients drank on a voluntary basis. Patients were followed prospectively for the incidence of emesis, dehydration and other complications. Results: Overall, emesis was experienced by 18% of patients in the post anesthesia care unit (PACU) and by 20% at home. Fifty percent of patients in the encouraged group versus 31% in the voluntary group reached the goal volume of oral liquids (p < 0.05). The incidence of emesis was higher in both the encouraged (41% versus 14%) and voluntary group (40% versus 26%) when the goal volume of 240 ml was reached. There was no statistically significant difference between the two groups in terms of duration of PACU stay, incidence of emesis, number of episodes of emesis or volume of emesis. Further, there was no difference between the two groups in terms of post-operative complications including dehydration. Conclusions: The current practice of a mandatory trial of oral fluid intake in the postoperative period may not be a necessary requirement for discharge. Further, mandatory oral fluids may result in a higher incidence of emesis. (C) 2005 Elsevier Ireland Ltd. All rights reserved.