title: The effect of postoperative fasting on vomiting in children and their assessment of pain.
abstract: BACKGROUND
  Mandatory postoperative food intake has been shown to increase nausea and vomiting, and so postoperative fasting has become common practice even if patients request food or drink.
  
  
  OBJECTIVE
  We sought to investigate whether postoperative fasting reduces the incidence of postoperative vomiting in children when compared with a liberal regimen in which they are allowed to eat and drink upon request.
  
  
  METHODS
  One hundred forty-seven children scheduled for outpatient surgery were randomized to one of two groups. After anesthesia, patients in the 'fasting' group were expected to fast for 6 h. The children in the 'liberal' group were allowed to eat and drink according to their own needs. The incidence of vomiting and the children's well-being were recorded at several time points over a 24-hour period. Parents were also asked to rate, on a scale of 0-6, how much their children were bothered by fasting, pain, and nausea/vomiting.
  
  
  RESULTS
  Age (4.8 +/- 2.6 years), weight (20 +/- 9 kg) and gender (73% boys) were comparable between the groups. The incidence of vomiting was 15% in the liberal and 22% in the fasting group (P = 0.39) and, between 1 and 12 h after extubation, children in the liberal group were significantly happier (P < 0.001). Children in the liberal group were significantly less bothered by their pain than those in the fasting group (P < 0.001).
  
  
  CONCLUSIONS
  Postoperative fasting did not reduce the incidence of vomiting after general anesthesia in children when compared with a liberal regimen. Furthermore, the ability to eat and drink at will decrease the bothersome aspects of pain and lead to happier patients.
authors.affiliation: Perioperative Clinical Research Core, Department of Anesthesia and Perioperative Care, University of California at San Francisco, UCSF Medical Center at Mount Zion, San Francisco, CA 94115, USA.
authors.forename: Oliver C
authors.initials: OC
authors.lastname: Radke
authors.forename: Andreas
authors.initials: A
authors.lastname: Biedler
authors.forename: K
authors.initials: K
authors.lastname: Kolodzie
authors.forename: Ozlem S
authors.initials: OS
authors.lastname: Cakmakkaya
authors.forename: Malte
authors.initials: M
authors.lastname: Silomon
authors.forename: Christian C
authors.initials: CC
authors.lastname: Apfel
mesh_terms: D000768:Anesthesia, General / Q000009:adverse effects*; D018685:Anesthetics, Inhalation / Q000008:administration & dosage / Q000009:adverse effects; D018686:Anesthetics, Intravenous / Q000008:administration & dosage / Q000009:adverse effects; D002675:Child, Preschool; D005215:Fasting; D005260:Female; D006801:Humans; D007530:Isoflurane / Q000008:administration & dosage / Q000009:adverse effects; D008297:Male; D010147:Pain Measurement / Q000379:methods / Q000706:statistics & numerical data*; D017060:Patient Satisfaction / Q000706:statistics & numerical data; D011182:Postoperative Care / Q000379:methods*; D020250:Postoperative Nausea and Vomiting / Q000139:chemically induced* / Q000517:prevention & control; D011184:Postoperative Period; D015742:Propofol / Q000008:administration & dosage / Q000009:adverse effects; D013874:Thiopental / Q000008:administration & dosage / Q000009:adverse effects
chemical_list: D018685:Anesthetics, Inhalation; D018686:Anesthetics, Intravenous; D007530:Isoflurane; D013874:Thiopental; D015742:Propofol