Key result
On-demand postoperative oral feeding significantly improved patient satisfaction compared to predetermined feeding, without increasing postoperative nausea and vomiting (21.7% vs 25.0%, p=0.666).
Why the study?
Early oral feeding is crucial in ERAS, but ensuring safety, natural progression to oral intake, and patient satisfaction requires evaluation.
Does on-demand postoperative oral feeding improve patient satisfaction and reduce postoperative nausea and vomiting compared to predetermined timing in patients undergoing elective cholecystectomy?
RCT (n=120)
Outcome assessor-blind
Randomly allocated using a sealed envelope technique
No
Does on-demand postoperative oral feeding improve patient satisfaction and reduce postoperative nausea and vomiting compared to predetermined timing in patients undergoing elective cholecystectomy?
Absolute Event Rate: 21.7% vs 25%
p-value: p=0.666
On-demand postoperative oral feeding after elective laparoscopic cholecystectomy significantly improves patient satisfaction without increasing the risk of postoperative nausea and vomiting compared to a predetermined 4-hour fasting schedule.
May allow flexible on-demand feeding after cholecystectomy; extends ERAS evidence from this RCT.
Background and aims Commencing early oral feeding soon after surgery is a crucial element of enhanced recovery after surgery (ERAS). However, it is imperative to ensure safety with a natural progression to oral intake and patient satisfaction. In this prospective, randomized, outcome assessor-blind controlled study, we aim to compare the efficacy of postoperative feeding on-demand versus predetermined timing in patients undergoing elective cholecystectomy under general anesthesia. Materials and methods A total of 120 patients (18 to 60 years, either gender) with American Society of Anaesthesiologists (ASA) physical status I-II, meeting inclusion criteria, and from the Department of General Surgery and Surgical Gastroenterology, were randomly allocated into two groups of 60 patients each. In the On-Demand group (Group OD), upon their request, patients received 200 ml of coconut water orally in small aliquots as per their comfort once fully awake. In the Predetermined-Time group (Group OT), patients received the same volume of coconut water at four hours post-surgery. The time of initial oral intake in Group OD, the incidence of postoperative nausea and vomiting (PONV), and patient satisfaction in both groups were assessed. Results There was no difference in the incidence of PONV between Group OD (13; 21.7%) and Group OT (15; 25%) (p=0.666). The majority of patients in both groups, 39 (65%) in Group OD and 40 (68%) in Group OT requested food within the initial ≤ 2 hours. Furthermore, overall satisfaction was significantly higher in Group OD compared to Group OT (p < 0.001). Conclusions Allowing postoperative oral feeding upon patient request enhances satisfaction without compromising safety as compared to adhering to predetermined schedules.
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Lamo et al. (2024) conducted an RCT in Elective laparoscopic cholecystectomy (n=120). On-demand postoperative oral feeding vs. Predetermined feeding (200 ml of coconut water 4 hours post-surgery) was evaluated on Incidence of postoperative nausea and vomiting (PONV) (p=0.666). On-demand postoperative oral feeding significantly improved patient satisfaction compared to predetermined feeding, without increasing postoperative nausea and vomiting (21.7% vs 25.0%, p=0.666).
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