The Feasibility And Safety Of Early Drinking Water After Endotracheal Intubation And General Anesthesia In The Elderly

Objective:With the general trend of aging population and the continuous development of medicine,the proportion of the elderly in surgical operations after general anesthesia is increasing.Due to the influence of various factors such as tracheal intubation,long-term water prohibition and fluid management,general anesthesia operation may cause discomfort such as thirst and dry mouth.The traditional idea is that water should be banned for 6 hours after surgery,which will increase the anxiety and discomfort of patients,and also goes against the pursuit of comfortable medical treatment in our new era.The proposal of early drinking water after general anesthesia solves this problem well,and it has been implemented and studied in some nongastrointestinal surgeries.However,for the elderly,there are still few reports on this aspect,mainly considering the safety and feasibility of early drinking water.Therefore,we will conduct a prospective study to study the feasibility and safety of early drinking water after endotracheal intubation and general anesthesia in the elderly,and explore its influence on gastrointestinal function recovery.Methods:According to the inclusion and exclusion criteria,76 patients over 65 years old who underwent elective tracheal intubation and general anesthesia in our hospital from April 7,2022 to January 10,2023 were selected and randomly divided into two groups:early drinking water group and routine water prohibition group.The two groups were treated with the same anesthesia induction and maintenance methods,and were treated with multi-mode analgesia after surgery.After the tracheal catheter was pulled out,the early drinking group was evaluated and given room temperature water of no more than 0.5ml/kg following the principle of limiting the total amount and several small amounts.Oral humidification was only performed in the conventional water prohibition group,and water prohibition was performed for 6h after operation.After lying flat and resting for 5 minutes(T0),when the trachea was intubated(T1),when the endotracheal tube was removed 20 minutes(T2),when the water is finished(when the endotracheal tube was removed 40 minutes)(T3),when the water finished 20 minutes(when the endotracheal tube was removed 60 minutes)(T4),when the water finished 40 minutes(when the endotracheal tube was removed 80 minutes)(T5),when the water finished 60 minutes(when the endotracheal tube was removed 100 minutes)(T6),antrum cross-sectional area was measured.The cross-sectional area of antrum(CSA),gastric volume(GV)and gastric volumetric weight ratio(GV/W)were recorded and compared between the two groups at each time point.The time of first postoperative exhaust and defecation were compared between the two groups.The incidence of adverse events such as reflux,aspiration,abdominal pain,abdominal distension,nausea and vomiting,postoperative complications and length of stay were compared between the two groups.Results:Intra-group comparison:Compared with T0,the cross-sectional area of gastric antrum,gastric volume and the ratio of gastric volume to body weight in T3 and T4 were significantly increased in early drinking group(P<0.05),but there were no significant differences at other time(P>0.05).The gastric antrum cross-sectional area increased at T4(P<0.05),but there were no significant differences in gastric volume and gastric volume-to-body weight ratio at every time(P>0.05).Comparison between the two groups:there were significant differences in the cross-sectional area of gastric antrum,stomach volume and stomach volumetric weight ratio in T3 and T4(P<0.05),but no significant differences at other time(P>0.05).In the early drinking group,the time of first postoperative exhaust and defecation was significantly shortened(P<0.05).Before and after comparison of thirst degree between the two groups,thirst was significantly relieved in the early drinking group(P<0.05),but not in the conventional water prohibition group(P>0.05).There were no adverse events such as reflux,aspiration,abdominal pain or abdominal distension in the two groups.There were no significant differences in the incidence of nausea,vomiting and postoperative complications between the two groups,and no significant differences in the postoperative hospitalization days between the two groups(P>0.05).Conclusions:1.Early drinking water during anesthesia recovery period after endotracheal intubation and general anesthesia can effectively relieve thirst and dry mouth of patients and improve their comfort and satisfaction;2.Early drinking water after endotracheal intubation and general anesthesia can shorten the time of the first postoperative exhaust and defecation,which can effectively promote the recovery of gastrointestinal function;3.For elderly patients who meet the safety standards of drinking water,it is safe and feasible to provide early drinking water in the recovery period after tracheal intubation and general anesthesia by following the principle of small amount and multiple times and limiting the total amount.