Investigating Optimal Approaches to Postoperative Nil by Mouth: A Preliminary Exploratory Study in Paediatric Patients Protocol

Introduction: The literature extensively discusses preoperative fasting guidelines for pediatric patients(1). In contrast, postoperative Nil by Mouth (NBM) strategies in pediatric patients have received limited attention, baring a few articles (2,3). Practices regarding postoperative NBM vary, influenced by individual preferences and the nature of the surgical procedure, impacting patient safety   and recovery (2,3).

Major abdominal surgeries may necessitate a longer NBM period for the gastrointestinal tract to recover, while superficial surgeries, like circumcisions and hernia repairs, may have shorter NBM periods due to their minimal impact on the gastrointestinal system. The timing of introducing semisolid foods post-surgery varies among healthcare professionals, influenced by factors such as surgery type, patient condition, and institutional guidelines.

The European Society of Anaesthesiology recommends resuming liquid intake within 3 hours post-surgery in adults. Allowing normal food intake on the day of surgery in adults has shown positive effects, including a shorter time to bowel function resumption, reduced hospital stay, and fewer postoperative complications.

Postoperative fasting is crucial in pediatric daycare procedures, impacting discharge timing significantly. To address this, we are initiating a prospective randomized controlled trial in daycare pediatric surgeries. Our goal is to assess the feasibility of introducing a regimen involving clear fluids initially, followed by a transition to a soft diet based on the child’s recovery score, providing insights into determining the optimal postoperative Nil By Mouth (NBM) period for pediatric patients undergoing daycare surgeries.