The effectiveness of per-oral carbohydrate and electrolyte solution for enhanced recovery after surgery (ERAS) in pediatric surgery: A randomized clinical trial
Introduction: Preoperative fasting in children is necessary to prevent aspiration pneumonia, but prolonged fasting can lead to hypoglycemia, dehydration, electrolyte imbalance, and postoperative nausea and vomiting (PONV). Preoperative carbohydrate loading, part of Enhanced Recovery After Surgery (E...
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| Format: | Article |
| Language: | English |
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Elsevier
2025-04-01
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| Series: | Journal of Pediatric Surgery Open |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2949711625000097 |
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| author | Andi Ade Wijaya Ramlan Christopher Kapuangan Raihanita Zahra Rahendra Rahendra Komang Ayu Ferdiana Titis Prawitasari Willy Yant Kartolo Ivana Firman Andana Haris Nathasha Brigitta Selene |
| author_facet | Andi Ade Wijaya Ramlan Christopher Kapuangan Raihanita Zahra Rahendra Rahendra Komang Ayu Ferdiana Titis Prawitasari Willy Yant Kartolo Ivana Firman Andana Haris Nathasha Brigitta Selene |
| author_sort | Andi Ade Wijaya Ramlan |
| collection | DOAJ |
| description | Introduction: Preoperative fasting in children is necessary to prevent aspiration pneumonia, but prolonged fasting can lead to hypoglycemia, dehydration, electrolyte imbalance, and postoperative nausea and vomiting (PONV). Preoperative carbohydrate loading, part of Enhanced Recovery After Surgery (ERAS), may alleviate discomfort and improve recovery. Methods: This controlled trial randomized 137 children aged 1 to 12 years undergoing elective surgery lasting <6 h into two groups: Carbohydrate-Electrolyte (CE) fluid (n = 67) and clear water (CW) (n = 70). Participants received 50 mL/kg of the assigned fluid following the standard 6–4–1 fasting regimen (solid food, breast milk, clear fluids). Primary outcomes included comparisons of blood glucose and electrolyte levels before and after induction. Secondary outcomes assessed preoperative anxiety, thirst, hunger, PONV, emergence delirium (ED), and pain scores. Results: Blood glucose levels remained within normal limits with no significant differences between groups (p > 0.05), with the CW group exhibiting lower mean glucose levels. Electrolyte levels were similar across groups. Preoperative anxiety, hunger, and postoperative pain showed no significant differences, while preoperative thirst was higher in the CW group (P = 0.040). ED occurred in 5.9 % of patients, with significantly lower scores in the CE group (P = 0.010). Postoperative nausea was more prevalent in the CW group (19.1 %) compared to the CE group (6 %) (P = 0.036). Conclusion: Preoperative CE fluid administration stabilizes blood glucose and electrolyte levels while reducing preoperative thirst, postoperative nausea, and potentially ED compared to CW. These indicate that CE fluids may improve perioperative comfort and outcomes in pediatric patients. |
| format | Article |
| id | doaj-art-39aaae16a9f64cc7ab60db2d0631f35a |
| institution | OA Journals |
| issn | 2949-7116 |
| language | English |
| publishDate | 2025-04-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Journal of Pediatric Surgery Open |
| spelling | doaj-art-39aaae16a9f64cc7ab60db2d0631f35a2025-08-20T02:25:01ZengElsevierJournal of Pediatric Surgery Open2949-71162025-04-011010020010.1016/j.yjpso.2025.100200The effectiveness of per-oral carbohydrate and electrolyte solution for enhanced recovery after surgery (ERAS) in pediatric surgery: A randomized clinical trialAndi Ade Wijaya Ramlan0Christopher Kapuangan1Raihanita Zahra2Rahendra Rahendra3Komang Ayu Ferdiana4Titis Prawitasari5Willy Yant Kartolo6Ivana Firman7Andana Haris8Nathasha Brigitta Selene9Department of Anesthesiology and Intensive Care, Faculty of Medicine, Universitas Indonesia, Central Jakarta, DKI Jakarta 10430, Indonesia; Cipto Mangunkusumo Hospital, Central Jakarta, DKI Jakarta, 10430, Indonesia; Corresponding author at: Jl. Diponegoro No 71, Central Jakarta, Postal code 10430, Jakarta, Indonesia.Department of Anesthesiology and Intensive Care, Faculty of Medicine, Universitas Indonesia, Central Jakarta, DKI Jakarta 10430, Indonesia; Cipto Mangunkusumo Hospital, Central Jakarta, DKI Jakarta, 10430, IndonesiaDepartment of Anesthesiology and Intensive Care, Faculty of Medicine, Universitas Indonesia, Central Jakarta, DKI Jakarta 10430, Indonesia; Cipto Mangunkusumo Hospital, Central Jakarta, DKI Jakarta, 10430, IndonesiaDepartment of Anesthesiology and Intensive Care, Faculty of Medicine, Universitas Indonesia, Central Jakarta, DKI Jakarta 10430, Indonesia; Cipto Mangunkusumo Hospital, Central Jakarta, DKI Jakarta, 10430, IndonesiaDepartment of Anesthesiology and Intensive Care, Faculty of Medicine, Universitas Indonesia, Central Jakarta, DKI Jakarta 10430, Indonesia; Cipto Mangunkusumo Hospital, Central Jakarta, DKI Jakarta, 10430, IndonesiaDepartment of Child's Health, Faculty of Medicine, Universitas Indonesia, Central Jakarta, DKI Jakarta 10430, Indonesia; Cipto Mangunkusumo Hospital, Central Jakarta, DKI Jakarta, 10430, IndonesiaDepartment of Anesthesiology and Intensive Care, Faculty of Medicine, Universitas Indonesia, Central Jakarta, DKI Jakarta 10430, Indonesia; Cipto Mangunkusumo Hospital, Central Jakarta, DKI Jakarta, 10430, IndonesiaDepartment of Anesthesiology and Intensive Care, Faculty of Medicine, Universitas Indonesia, Central Jakarta, DKI Jakarta 10430, Indonesia; Cipto Mangunkusumo Hospital, Central Jakarta, DKI Jakarta, 10430, IndonesiaDepartment of Anesthesiology and Intensive Care, Faculty of Medicine, Universitas Indonesia, Central Jakarta, DKI Jakarta 10430, Indonesia; Cipto Mangunkusumo Hospital, Central Jakarta, DKI Jakarta, 10430, IndonesiaDepartment of Anesthesiology and Intensive Care, Faculty of Medicine, Universitas Indonesia, Central Jakarta, DKI Jakarta 10430, IndonesiaIntroduction: Preoperative fasting in children is necessary to prevent aspiration pneumonia, but prolonged fasting can lead to hypoglycemia, dehydration, electrolyte imbalance, and postoperative nausea and vomiting (PONV). Preoperative carbohydrate loading, part of Enhanced Recovery After Surgery (ERAS), may alleviate discomfort and improve recovery. Methods: This controlled trial randomized 137 children aged 1 to 12 years undergoing elective surgery lasting <6 h into two groups: Carbohydrate-Electrolyte (CE) fluid (n = 67) and clear water (CW) (n = 70). Participants received 50 mL/kg of the assigned fluid following the standard 6–4–1 fasting regimen (solid food, breast milk, clear fluids). Primary outcomes included comparisons of blood glucose and electrolyte levels before and after induction. Secondary outcomes assessed preoperative anxiety, thirst, hunger, PONV, emergence delirium (ED), and pain scores. Results: Blood glucose levels remained within normal limits with no significant differences between groups (p > 0.05), with the CW group exhibiting lower mean glucose levels. Electrolyte levels were similar across groups. Preoperative anxiety, hunger, and postoperative pain showed no significant differences, while preoperative thirst was higher in the CW group (P = 0.040). ED occurred in 5.9 % of patients, with significantly lower scores in the CE group (P = 0.010). Postoperative nausea was more prevalent in the CW group (19.1 %) compared to the CE group (6 %) (P = 0.036). Conclusion: Preoperative CE fluid administration stabilizes blood glucose and electrolyte levels while reducing preoperative thirst, postoperative nausea, and potentially ED compared to CW. These indicate that CE fluids may improve perioperative comfort and outcomes in pediatric patients.http://www.sciencedirect.com/science/article/pii/S2949711625000097Oral carbohydrate and electrolyte solutionEnhanced recovery after surgeryPostoperative nausea and vomitingEmergent deliriumPostoperative pain |
| spellingShingle | Andi Ade Wijaya Ramlan Christopher Kapuangan Raihanita Zahra Rahendra Rahendra Komang Ayu Ferdiana Titis Prawitasari Willy Yant Kartolo Ivana Firman Andana Haris Nathasha Brigitta Selene The effectiveness of per-oral carbohydrate and electrolyte solution for enhanced recovery after surgery (ERAS) in pediatric surgery: A randomized clinical trial Journal of Pediatric Surgery Open Oral carbohydrate and electrolyte solution Enhanced recovery after surgery Postoperative nausea and vomiting Emergent delirium Postoperative pain |
| title | The effectiveness of per-oral carbohydrate and electrolyte solution for enhanced recovery after surgery (ERAS) in pediatric surgery: A randomized clinical trial |
| title_full | The effectiveness of per-oral carbohydrate and electrolyte solution for enhanced recovery after surgery (ERAS) in pediatric surgery: A randomized clinical trial |
| title_fullStr | The effectiveness of per-oral carbohydrate and electrolyte solution for enhanced recovery after surgery (ERAS) in pediatric surgery: A randomized clinical trial |
| title_full_unstemmed | The effectiveness of per-oral carbohydrate and electrolyte solution for enhanced recovery after surgery (ERAS) in pediatric surgery: A randomized clinical trial |
| title_short | The effectiveness of per-oral carbohydrate and electrolyte solution for enhanced recovery after surgery (ERAS) in pediatric surgery: A randomized clinical trial |
| title_sort | effectiveness of per oral carbohydrate and electrolyte solution for enhanced recovery after surgery eras in pediatric surgery a randomized clinical trial |
| topic | Oral carbohydrate and electrolyte solution Enhanced recovery after surgery Postoperative nausea and vomiting Emergent delirium Postoperative pain |
| url | http://www.sciencedirect.com/science/article/pii/S2949711625000097 |
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