Key Learning Points:
  1. Shorter fasting times significantly improved PPPM scores on post-operative day 1.
  2. Even in the shorter fasting time group, patients’ fasting times were on average 1.5 hours longer than instructed.
  3. There were lower pain scores in the shorter fasting time group on post-operative days 1-3, however this was not statistically significant.
  4. There were slightly higher rates of post-operative nausea/vomiting in the shorter fasting time group, however not statistically significant.
  5. There was less use of oxycodone post-operatively in the shorter fasting time group, although not statistically significant.
1. Introduction: In the mid-1990’s a gap in understanding prompted a group of surgeons, led by Dr Henrik Kehlet from Copenhagen, to devise and implement early recovery efforts for certain surgeries. Building upon Dr Kehlet’s work, a multinational group of surgeons and anaesthetists started the Enhanced Recovery After Surgery(ERAS) research group. Interest in perioperative protocols has become increasingly used for colorectal surgery and gynaecologic surgery(2).
In the past two decades, protocols have been developed that have been found to reduce hospital length of stay, decrease infections and lower readmission rates(3). These protocols have been developed most notably for colorectal surgery and have taken hold across the United Kingdom, the United States and the European continent.
Tonsillectomy is a common operation associated with a high incidence of postoperative pain and significant postoperative nausea and vomiting. We seek to investigate a whether the length of fasting is associated with pain and return to normal function after tonsillectomy.