An Empirical Study On Early Feeding Nursing After Orthopedic General Anesthesia For Children

ObjectivesTo explore the influence of early feeding nursing on child orthopedic general anesthesia,and to provide reference for child orthopedic general anesthesia postoperative nursing.Methods1.Based on the evidence-based nursing method,we systematically searched and evaluated the relevant evidence of early feeding nursing after pediatric orthopedic sugery under general anesthesia,summarized the best evidence,and determined the nursing intervention measures after the localization of the evidence combined with the clinical situation.2.Using quasi experimental research method,142 children undergoing general anesthesia operation in Department of pediatric orthopedics of a tertiary hospital in Hunan Province from April to October 2020 were selected and divided into experimental group and control group according to the hospitalization period,which in April 2020 to July of hospitalized patients as control group(n =72),hospitalized children from August to October as the test group(n =70).The control group received routine nursing plan,and the experimental group received early feeding nursing plan.The two groups were compared for postoperative nausea and vomiting,abdominal distension,anal exhaust defecation time,body temperature,heart rate,blood oxygen saturation,pain,postoperative fluid volume,postoperative feeding time and other indicators.Results1.Comparison of general data: 296 relevant literatures were retrieved,and finally 10 literatures were included,including 3 guidelines,2 quasi experimental studies,and 5 RCTs.The best evidence summarized included 12 specific nursing measures in 3 aspects: pre eating evaluation,guidance during eating,and post eating evaluationthere;2.Baseline data comparison: there was no statistical difference in gender,age,BMI,ASA anesthesia grade,operation time,anesthesia time,preoperative diet ban time,anesthesia recovery time,operation type,intraoperative infusion volume,postoperative analgesia pump between the two groups(P > 0.05);3.There was no statistical difference in the incidence of nausea,vomiting and abdominal distension between the experimental group and the control group at different time points after operation(P > 0.05);4.The first anal exhaust and defecation time in experimental group were 6.01 ± 1.49 h and 12.17 ± 3.40 h,respectively,which were significantly lower than 12.17±3.40 h and 12.17±3.40 h in control group,and the difference was statistically significant(P<0.05).5.There were time effects and interaction effects in the comparison of body temperature and heart rate at each time point after operation between the experimental group and the control group,the difference was statistically significant(P < 0.05),and there were time effects in the comparison of blood oxygen saturation at each time point after operation between the two groups,the difference was statistically significant(P <0.05);6.There were time effect and interaction effect in the comparison of pain level after operation between the experimental group and the control group,the difference was statistically significant(P < 0.05);7.The first time of water intake in the experimental group was 0.67±0.48 h and 1.92±0.96 h,respectively,which were significantly lower than those in the control group(4.07 ± 0.26 h and 7.97 ± 1.78h),the difference was statistically significant(P<0.05).8.The amount of postoperative fluid rehydration in the experimental group was 248.0±79.17 m L,significantly lower than that in the control group(508.75±182.48 m L),the difference was statistically significant(P<0.05).Conclusions1.This study based on the evidence-based nursing method,and the early feeding nursing program for children after general anesthesia in orthopedics department has clear indications,clear steps and strong clinical practicability.2.The early feeding nursing program after pediatric orthopedic surgery under general anesthesia can effectively shorten the time of no eating time after surgery,reduce the amount of postoperative infusion,promote postoperative anal exhaust and defecation,without increasing gastrointestinal adverse reactions,which can help to maintain the stability of children’s postoperative vital signs.