YUNUS OKTAY ATALAY, CENGİZ KAYA, ERSİN KÖKSAL, Yasemin Burcu ÜSTÜN, LEMAN TOMAK

Determining a Safe Time for Oral Intake Following Pediatric Sedation

Amaç: Genel anestezi sonrası oral sıvı alımı zamanı ile il- gili öneriler bulunmakla birlikte, sedasyon ile ilgili yayınla- nan herhangi bir çalışma yoktur. Bu prospektif çalışmanın amacı pediatrik sedasyon sonrası oral ilk alım için güvenli zamanını belirlemek, bunun taburculuk sonrası bulantı kusma ile ilişkisini saptamaktır. Yöntemler: Manyetik rezonans görüntüleme için sedas- yon uygulanan 180 çocuk (1 ay -13 yaş) rastgele üç gruba ayrıldı. Tüm hastalar tiyopental (3 mg/ kg) ile sedasyon öncesi 6 saat aç bırakıldı; 2 saat öncesine kadar berrak sıvı almalarına izin verildi. Derlenme odasına transfer sonrası grup I deki hastaların taburcu edilmeden hemen önce, grup II deki hastaların taburcu edilme kriterlerini karşıladıktan 2 saat sonra, grup III deki hastaların ise taburcu edilme kriterini karşılaştırdıktan 3 saat sonra di- ledikleri kadar oral berrak sıvı almalarına izin verildi. Tüm hastalar oral sıvı aldıkları zamandan 1 saat sonrasına kadar derlenme odasında kusma açısından takip edildi. Hastaların aileleri ertesi gün telefonla aranarak bulantı/ kusma, umulmadık hastane başvurusu açısından sorgu- landı. Bulgular: Gruplar arasında yaş, cinsiyet, vücut ağırlığı ya da ASA fiziksel durum sınıflaması açısından istatistiksel olarak anlamlı bir fark saptanmadı. Grupların hiçbirinde derlenme odası ve taburculuk sonrası bulantı ve kusma, telefon sorgulamasında umulmadık hastane başvurusu yoktu. Sonuç: Tiyopental ile sedatize edilen hastaların taburcu- luktan hemen önce oral sıvı alımı güvenli olup taburcu edildikten sonra aç kalmalarına gerek yoktır.

Pediatrik Sedasyon Sonrası Oral Alım için Güvenli Zamanın Belirlenmesi

Objective: While there are suggestions for oral hydra- tion times after general anesthesia, there is no published study with regard to sedation. The aim of this prospective study was to determine a safe time for oral intake after pediatric sedation and its association with nausea and vomiting after discharge. Methods: A total of 180 children (aged 1 month to 13 years) sedated for magnetic resonance imaging were randomly assigned into three groups. All patients fasted for 6 hours and were allowed to take clear fluids until 2 hours before sedation with thiopental (3 mg/kg). After the patients were transported to the recovery room, we al- lowed the patients to drink as much clear fluids as they wanted prior to discharge in group I, 1 hour after the pa- tients met the discharge criteria for group II, and 2 hours after the patients met the discharge criteria for group III. All patients were assessed for vomiting in the recovery room until 1 hour after their first oral hydration. The par- ents were then telephoned the next day and questioned regarding nausea/vomiting and any unanticipated hospi- tal admission. Results: There were no statistically significant intergroup differences with respect to age, sex, weight, or the ASA status. There was no nausea and vomiting in either the recovery or post discharge period in any group. In the telephone questionnaire, no hospital admissions were reported. Conclusion: Oral hydration just before discharge is safe, and fasting children after discharge for a period of time is unnecessary for patients sedated with thiopental.

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