SHOULD ADULT PATIENTS DRINK FLUIDS BEFORE DISCHARGE FROM AMBULATORY SURGERY

We studied 726 consenting patients to determine whether withholding or al fluids from adult ambulatory surgical patients before discharge wou ld decrease the incidence of postoperative nausea and vomiting (PONV) and shorten the duration of stay in the ambulatory surgery unit (ASU). Patients were randomly assigned to the drinking or nondrinking group. Both groups received a standard regimen of general anesthesia, fluid replacement, and analgesia. In the ASU, patients in the drinking group were given mandatory oral fluids to drink before discharge. Nausea an d pain were assessed by using a visual analog scale 15, 30, 60, 90, 10 5, 120, 150, and 180 min postoperatively. The time to drink, sit up, v oid, and ambulate, and the time until discharge were recorded. Patient s were interviewed by telephone 24 h postoperatively. There was no sig nificant difference in the frequency of PONV between the drinking and the nondrinking groups either in the hospital or after discharge. Pati ents in the drinking group required more time to begin ambulating (105 +/- 38 vs 98 +/- 34 min; P < 0.02) and to void (112 +/- 40 vs 105 +/- 37 min; P < 0.01). Patients in the drinking group also stayed in the ASU longer (85 +/- 49 vs 81 +/- 47 min; P < 0.03). Time to postanesthe tic discharge was also significantly longer in the drinking group than the nondrinking group (106 +/- 40 vs 98 +/- 36 min; P < 0.015). A sim ilar percentage of patients in both groups were ''very satisfied'' wit h their ambulatory surgical care. There was no difference in postopera tive complications and need for medical help. Withholding early postop erative oral fluids facilitated earlier ambulation and decreased the s tay in the ASU but did not decrease the incidence of PONV. Thus, in th is ambulatory surgical population, there does not seem to be justifica tion to require drinking before discharge. Implications: To answer the question of whether adult outpatients should drink before discharge a fter minor surgical procedures, 726 patients were randomized to either drink approximately 150 mt of liquid or not to drink. Neither drinkin g nor nondrinking worsened postoperative nausea or vomiting or prolong ed hospital stay. Therefore, patients should be allowed to choose whet her they drink before discharge.