21–24 A guideline from the European Society of Anaesthesiology and Intensive Care recommends that patients resume drinking soon after elective surgical procedures. 19 20 Previous studies have supported early intake after gastrointestinal surgery and total laryngectomy, with some guidelines recommending early oral feeding after surgery. 15–18 As an important part of perioperative nutrition, early feeding after surgery has been shown to accelerate postoperative bowel function recovery. 12 Various studies and guidelines have clearly recommended preoperative fasting times, 13 14 and preoperative fasting abbreviation protocols such as enhanced recovery after surgery could avoid nausea, vomiting and ileus and accelerate postoperative recovery. 11 Chewing gum, the advent of laparoscopy, and perioperative nutrition are beneficial in the recovery of bowel function and prevention of postoperative ileus. PONV occurred in 23.6% of the patients, and no paralytic ileus was observed.Ī previous study demonstrated that risk factors, including opioid use, surgical complexity and fluid overload, are associated with postoperative ileus. Furthermore, the time to initiate drinking or eating was significantly earlier than the time to FFL or FFE. Notably, the instructed postoperative fasting time did not differ regardless of the surgery or anaesthesia type. The actual initiation times for oral fluid and solid food intake were significantly higher than those instructed by the ward staff. This multicentre study demonstrated that all patients received information regarding postoperative intake initiation from ward staff. Therefore, the present multicentre study was designed to explore actual oral intake practices after surgery.
9 Patients were also confused about when to start oral intake, and had to endure thirst and hunger. 7 8 Even in guidelines, there were little data about how early is ‘early’. 5 6 Meanwhile, a gap between clinical practice and feeding evidence or guidelines is common.
1–4 Postoperative care in major gynaecologic surgery even recommends oral intake immediately after surgery. In contrast, evidence indicates that early postoperative oral intake is safe and beneficial, even in gastrointestinal surgery. However, there is little evidence to support the traditional postoperative oral nutrition regime. It is believed that tradition can reduce the incidence of paralytic ileus or anastomotic leakage. This traditional approach has been used to prevent postoperative complications. Traditional postoperative oral nutrition is usually initiated after the indication of return of bowel function, including passage of flatus, passage of stool and bowel sounds.
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