Effects of a preoperative carbohydrate drink on postoperative recovery after day-surgery in children; The Sweet Dreams Trial.

INTERVENTION: The intervention group will receive a 200 mL of a carbohydrate‐containing orange‐flavoured drink. The drink will be given 2 hours prior to induction of the general anaesthetic. The carbohydrate load will be calculated based on the child age: 40 gr for 2‐5 years old; 55 gr for 6‐10 years old; 70 gr for 11‐15 years old. The drink will be administered by the nursing staff which will ensure that all drink is consumed. CONDITION: Blood sugar control Post‐operative recovery following general anesthesia and day surgery. PRIMARY OUTCOME: This is a composite primary outcome. ; Analgesic and anti‐emetic medications requirement and number of post‐operative vomits. ; These outcomes will be prospectively collected from the hospital records. This is a composite primary outcome. ; Post‐operative nausea ; Assessed using a validated visual analogue scale (0‐10 score); ; 0 = no nausea ; 10 = extreme nausea ; ; And a 4‐point verbal descriptive scale ; 0 = no nausea ; 1 = mild ; 2 = moderate ; 3 = severe This is a composite primary outcome. ; Post‐operative pain; ; Assessed using the validated Wong‐Baker Faces Pain Rating Scale (0‐10) ; 0 = No pain ; 10 = Severe pain ; ; And a Behavioural scale (FLACC scale ‐ Face, legs, activity, cry, consolability) ; Scored from 0‐10 ; Face ; 0 = No particular expression or smile ; 1 = Occasional grimace or frown, withdrawn, disinterested ; 2 = Frequent to constant frown, quivering chin, clenched jaw ; Legs ; 0 = Normal position or relaxed ; 1 = Uneasy, restless, tense ; 2 = Kicking or legs drawn up ; Activity ; 0 = Lying quietly, normal position, moves easily ; 1 = Squirming, shifting back and forth, tense ; 2 = Arched, rigid, or jerking ; Cry ; 0 = No cry (awake or asleep) ; 1 = Moans or whimpers, occasional complaint ; 2 = Crying steadily, screams or sobs, frequent complaints ; Consolability ; 0 = Content, relaxed ; 1 = Reassured by occasional touching, hugging, or being talked to; distractile ; 2 = Difficult to console or comfort ; SECONDARY OUTCOME: Blood glucose. ; Obtained via capillary (finger‐prick) blood sample measured by a glucose meter. Blood ketones. ; Obtained via capillary (finger‐prick) blood sample measured by a ketone meter. Post‐operative wellbeing measured using an irritability questionnaire completed by the parents. The questionnaire was adapted from the validated Swanson, Nolan and Pelham (SNAP) Questionnaire (Swanson et al, 1983). Time to discharge. This will be prospectively collected from the hospital records. ; INCLUSION CRITERIA: 1. Children aged 2 years to 15 years 2. Undergoing a day procedure 3. With no significant associated co‐mobidities (American Society of Anaesthesiologists Classification of Physical Status [ASA] Grade 1)