Determining a Safe Time for Oral Intake Following Pediatric Sedation

Epidemiology and Endoscopic Findings of the Patients Suffering from Upper Gastrointestinal System Bleeding

Mehmet YALÇIN, Banu KARA, Nevin A ÖZTÜRK, Şehmus ÖLMEZ, Burçak E. TAŞDOĞAN, Adnan TAŞ

Abstract

Objective: While there are suggestions for oral hydration 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 allowed the patients to drink as much clear fluids as they wanted prior to discharge in group I, 1 hour after the patients 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 parents were then telephoned the next day and questioned regarding nausea/vomiting and any unanticipated hospital 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.Key words: Sedation, oral intake, postoperative nausea and vomiting

Özet

Objective: In the present study, we aim to investigate general and endoscopic findings of the patients who were hospitalized in our clinic because of upper gastrointestinal system bleeding (UGSB).Methods: The files of 403 patients who applied to our clinic between January 2014 and December 2014 with UGSB diagnosis were scanned retrospectively. The demographic, laboratorial and endoscopic findings of the patients were examined.Results: The average age of 403 patients were 61.12±17.1 (min. 17- max. 96) and while 263 of these patients were male (65.3(%), 140 of them were female (34.7%). Of all, 234 patients had an additional disease. The most frequently observed diseases were hypertension, diabetes mellitus and coronary artery. 259 (64.3%) of the patients used to take at least one drug and 212 (52.6%) of the patients used to get non-steroid anti-inflammatory drugs and/or aspirin. The most common reasons of UGSB were duodenal ulcer in 158 patients (39.2%), stomach ulcer in 97 patients (24%), erosive gastroduodenitis in 66 patients (16.3%) and esophageal varices in 38 patients (9.4%). Unfortunately, 18 of the patients died.Conclusion: The most common reason of UGSB is duodenal ulcer bleeding. In spite of the technological development nowadays, it is a disease which has mortality.Key words: Upper gastrointestinal system bleeding, duodenal ulcer, gastric ulcer, variceal hemorrhage

Keywords: Üst gastrointestinal kanama, duodenum ülseri, gastrik ülser, varis kanaması