A randomized evaluation of early oral feeding after ambulatory non-gastrointestinal surgical patients under general anesthesia.

BACKGROUND

The optimal timing and safety of early oral feeding after non-gastrointestinal surgery under general anesthesia remain unclear, particularly in ambulatory settings. This study aims to evaluate the impact of an evidence-based early oral feeding strategy on postoperative adverse events, patient comfort, and gastrointestinal recovery in patients undergoing day case non-gastrointestinal surgery.

METHODS

A total of 117 patients were allocated to an intervention group (n = 62) receiving an early oral feeding protocol based on Steward Recovery Score and Apfel PONV risk assessment, or a control group (n = 55) following a conventional 2-4-6 h fasting protocol. Outcomes included time to first oral intake, incidence of nausea, vomiting, choking, abdominal distension, thirst and hunger VAS scores, pain NRS scores, postoperative infusion volume, and time to first flatus.

RESULTS

The intervention group had significantly earlier first drink and meal times (P < 0.001). The incidences of nausea and vomiting at 2 h were reduced to 12.90% and 6.45%, significantly lower than the control group (29.09% and 16.36%, P < 0.05). Multivariable logistic regression identified early feeding as an independent protective factor, associated with a 63.9% reduction in the odds of nausea (AOR = 0.361) and a 79.7% reduction in the odds of choking (AOR = 0.203) at 2 h postoperatively. Thirst, hunger, pain scores, alongside postoperative infusion volume were all significantly lower in the intervention group (all P < 0.001). Time to first flatus was markedly shortened in the intervention group (P < 0.001).

CONCLUSION

In patients undergoing ambulatory non-gastrointestinal procedures with comparable discharge criteria, the early feeding protocol produced clinically meaningful improvements in patient-centered outcomes: early postoperative comfort was significantly enhanced through substantial reductions in thirst and hunger VAS scores, while the odds of early PONV were reduced. These findings support implementing this protocol in similar ambulatory surgical settings to improve recovery quality.