Improvement in the duration of pre-operative fasting in children

Abstract

Source of discomfort and dissatisfaction, the rules of pre-operative fasting have evolved a lot in recent years.Objective: To evaluate the duration of preoperative fasting in children and the degree of parental support for this strategy. Materials and Methods:Prospective mono-centric study on the implementation of a preoperative fasting strategy in children. Pediatric surgery department of the Teaching University Hospital (TUH) of Sidi-Bel-Abbès over a period of three years from July 2015 to June 2018. Included were all children from 6 months-15 years, who are asked the indication of anesthesia for minor surgery. We gathered the respect and understanding of the parents of preoperative fasting.Results: One thousand three children were included in the study, the mean age was: 62.01 ± 44.14 months, the sex ratio was 3.6/1 with male predominance. The majority of children were under six years old. The socio-cultural level of parents was medium to high in 88.4% of cases. The mean duration of preoperative fasting was 6.9 ± 4.16 hours and ranged from 2 hours to more than 11 hours. Almost 70% of children had a six-hour fast during the second year.Discussion: In our work, the vast majority of parents respected the pre-op fasting of their children. The improvement in the duration of preoperative fasting was done through a follow-up protocol by the entire pediatric surgery team. The application of the rules of fasting by parents must be strict and simple.

The actual duration of preoperative fasting in pediatric patients, and its effects on hunger and thirst: a prospective observational study

“…Even though ASA had revised preoperative fasting guideline since 2011 to decrease fasting time for clear liquid from 6 to 2 h (32), recent studies published after 2020 still reported prolonged fasting times for food and clear liquid between 11-14 and 2-12 h (5, [13][14][15][16]18,26), respectively. Pediatric studies regarding preoperative fasting were described in Table 4 (13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24). Our prolonged fasting time for clear liquid was in contrast to other studies that were successful in reducing the mean fasting time for clear liquid to less than 4 h (17,21).…”

“…The real-world fasting time reported in pediatric studies after 2010 was unnecessarily prolonged especially for clear liquid. The mean fasting times for food and clear liquid were 7.8-14.0 h (12-24) and 2.3-12.3 h, respectively (13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24). Multiple perioperative complications had been described after extensive fasting such as hypotension after anesthesia induction (25,26), ketosis (23), increased incidence of postoperative nausea and vomiting (27), and patient discomfort (16).…”