Ultra-Early Oral Hydration for General Anesthesia Patients in the Postanesthesia Care Unit: A Meta-analysis of Randomized Controlled Trials.
Abstract
Purpose
To systematically evaluate the effects of ultra-early oral hydration versus delayed oral hydration in the postanesthesia care unit (PACU) on postoperative nausea and vomiting, recovery outcomes, and patient satisfaction in adults undergoing nongastrointestinal surgery with general anesthesia.
Design
Systematic review and meta-analysis.
Methods
Randomized controlled trials (RCTs) published from database inception to October 1, 2025, were retrieved from PubMed, Embase, Web of Science, the Cochrane Library, Sinomed, China National Knowledge Infrastructure (CNKI), Wanfang Data, and VIP Chinese Journal Database. The Cochrane Risk of Bias Tool was used to assess methodological quality. Meta-analysis was performed using RevMan 5.4 and Stata 18.0 software. The certainty of evidence was evaluated using the Grading of Recommendations, Assessment, Development, and Evaluation approach.
Findings
A meta-analysis of 10 RCTs showed that ultra-early oral hydration in the PACU did not increase the risk of vomiting (RR = 0.70, 95% CI: 0.46 to 1.07, P = 0.10), but significantly reduced the incidence of nausea (RR = 0.76, 95% CI: 0.60 to 0.97, P = 0.03), all with moderate certainty of evidence. Additionally, ultra-early oral hydration alleviated thirst discomfort (SMD = -2.12, 95% CI: -2.72 to -1.52, P <0.01), shortened the time to first flatus (MD = -5.60 h, 95% CI: -8.94 to -2.25, P <0.01), and boosted patient satisfaction during recovery (SMD = 1.48, 95% CI: 0.48 to 2.47, P < 0.01), all with low certainty of evidence.
Conclusions
Current evidence from RCTs indicates that ultra-early oral hydration in the PACU may reduce postoperative nausea, relieve thirst discomfort, accelerate gastrointestinal recovery, and improve patient satisfaction in adults undergoing nongastrointestinal surgery, without significantly increasing the risk of vomiting. However, further high-quality and standardized studies are needed to confirm these conclusions.