IMPACT OF EARLY ENTERAL FEEDING WITH WATER ON POSTOPERATIVE THIRST AND DISCOMFORT: A RANDOMISED CONTROLLED TRIAL

Abstract

Background: Postoperative thirst and oropharyngeal discomfort are among the most common and distressing symptoms experienced following general anaesthesia. Prolonged perioperative fasting and airway instrumentation contribute significantly to patient discomfort and may adversely affect recovery quality. Early oral hydration has been proposed as a simple intervention to improve postoperative recovery and is increasingly advocated within Enhanced Recovery After Surgery (ERAS) pathways. However, evidence regarding its effectiveness and safety in daycare surgical patients remains limited. Aim: To evaluate the effectiveness and safety of early oral water intake following recovery from general anaesthesia in patients undergoing daycare surgical procedures. Methods: A prospective randomized controlled trial was conducted among 108 adult patients undergoing daycare surgery under general anaesthesia. Participants were randomly allocated into two groups: Group A (n=54), which received standard postoperative fasting care, and Group B (n=54), which received early oral water intake at a dose of 1 mL/kg following recovery from anaesthesia after achieving a Postoperative Recovery Functional Index (PROFI) score of 6/6. The primary outcome was postoperative comfort score. Secondary outcomes included postoperative thirst, oropharyngeal discomfort, and postoperative nausea and vomiting (PONV). Statistical analysis was performed using the Chi-square test and Student's t-test, with p<0.05 considered statistically significant. Results: Baseline demographic and perioperative characteristics were comparable between the two groups. Postoperative thirst was significantly lower in Group B compared with Group A (33.3% vs. 75.9%, p<0.001). Similarly, the incidence of oropharyngeal discomfort was significantly lower in Group B than in Group A (29.6% vs. 70.4%, p<0.001). Patients receiving early oral hydration demonstrated significantly higher postoperative comfort scores compared with the control group (8.22 ± 0.87 vs. 5.94 ± 1.15, p<0.001). Although the incidence of postoperative nausea and vomiting was lower in Group B than in Group A (13.0% vs. 16.7%), the difference was not statistically significant (p=0.590). No aspiration related events or other hydration-related complications were observed. Conclusion: Early oral water intake following recovery from general anaesthesia is a safe, simple, and effective intervention in daycare surgical patients. Early hydration significantly reduces postoperative thirst and oropharyngeal discomfort while substantially improving patient comfort without increasing postoperative nausea and vomiting or other complications. These findings support the incorporation of structured early oral hydration protocols into routine perioperative and ERAS-based recovery pathways.