title: The effect of preoperative fasting on postoperative thirst, hunger and oral intake in paediatric ambulatory tonsillectomy.
abstract: OBJECTIVE
  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.
  
  
  METHODS
  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.
  
  
  CONCLUSIONS
  Clinical practice should take the child's perioperative fasting into account in a more accurate way in preoperative counselling of the parents.
authors.affiliation: Department of Nursing Science, University of Turku, Turku, Finland. seija.klemetti@utu.fi
authors.forename: Seija
authors.initials: S
authors.lastname: Klemetti
authors.forename: Ilpo
authors.initials: I
authors.lastname: Kinnunen
authors.forename: Tarja
authors.initials: T
authors.lastname: Suominen
authors.forename: Heikki
authors.initials: H
authors.lastname: Antila
authors.forename: Tero
authors.initials: T
authors.lastname: Vahlberg
authors.forename: Reidar
authors.initials: R
authors.lastname: Grenman
authors.forename: Helena
authors.initials: H
authors.lastname: Leino-Kilpi
mesh_terms: D000284:Administration, Oral; D000556:Ambulatory Surgical Procedures; D002648:Child; D005215:Fasting; D006801:Humans; D006815:Hunger; D010147:Pain Measurement; D011184:Postoperative Period; D057234:Preoperative Period; D011446:Prospective Studies; D011795:Surveys and Questionnaires; D013894:Thirst; D014068:Tonsillectomy