Preoperative Starvation and Blood Glucose Concentrations in Children Undergoing Inpatient and Outpatient Anaesthesia

Jensen, Brian; Wernberg, M; Andersen, Mads

doi:10.1097/00132586-198308000-00039

Cited by 15 publications

(17 citation statements)

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“…It was observed that children who are given glucose-containing clear liquids close to the time of anaesthesia are less irritable and thirsty than those who are fasted for 6-8 h (Schreiner, Triebwasser & Keon 1990). 'Some authors postulated that drinking glucose-containing solutions should prevent perioperative hypoglycaemia, and therefore bypass the controversy surrounding the intraoperative administration of glucose-containing solutions (Watson 1972;Thomas 1974;Kelnar 1976;Graham 1979;Jensen, Wernberg & Andersen 1982;Nilsson et al 1984;Payne & Ireland 1984;Welborn ef al. 1986;Welbom et al 1987).…”

Section: Introductionmentioning

confidence: 99%

Effect of minimizing preoperative fasting on perioperative blood glucose homeostasis in children

Welborn

Norden

Seiden

et al. 1993

Pediatric Anesthesia

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Summary Two hundred healthy, unpremedicated children, ages 1–10 years, scheduled for elective outpatient surgery were studied in order to examine the effect of minimizing preoperative fasting on perioperative blood glucose concentrations in paediatric patients. None of the patients ingested solids after midnight. On the day of surgery, the children were assigned to one of two groups. Group A children (n= 113) were not allowed any liquids for at least 6 h prior to surgery (NPO). Children in Group B (n= 87) ingested 10 ml·kg−1 of apple juice 2–4 h prior to the induction of anaesthesia. All patients received lactated Ringer's solution intraoperatively, unless BG at induction was < 50 mg·dl−1 (2.8 m·mol·l−1) in which case dextrose 2.5% in lactated Ringer's solution was administered. None of the patients who received apple juice was hypoglycaemic during induction of anaesthesia. However, two children in the NPO group had blood glucose values ± 50 mg·dl−1 (2.8 m·mol·l−1) at the time of induction of anaesthesia. Thirteen (11%) patients in Group A and 6 (7%) patients in Group B showed either no change or a further decrease in their postoperative BG concentration as compared with their induction values. Two of 43 patients in Group A and 2 of 41 patients in Group B had gastric fluid volumes > 0.4 ml/kg. All patients in both groups had gastric pH < 2.5. This study shows that gastric fluid volume and pH following a 2–4 h fast are not different from the values measured in children who were subjected to a traditional fasting period of 6 h or longer. Moreover, apple juice consumed 2–4 h prior to surgery neither buffers gastric pH nor does it modify intraoperative glucose homeostasis in children.

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Section: Introductionmentioning

confidence: 99%

Effect of minimizing preoperative fasting on perioperative blood glucose homeostasis in children

Welborn

Norden

Seiden

et al. 1993

Pediatric Anesthesia

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“…S1). We compared our values with those from earlier studies (16)(17)(18)(19)(20)(21) (Table S2). We recorded some values above 5.5 mmol/L; indeed, one child had a remarkably high fasting plasma glucose value of 6.1 mmol/L.…”

Section: Resultsmentioning

confidence: 99%

Fasting plasma glucose levels in healthy preschool children: effects of weight and lifestyle

Ludvigsson¹,

Huus²,

Eklöv³

et al. 2007

Acta Paediatrica

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“…Neonates are also at risk of hypoglycaemia during surgery, particularly if glucose solutions have been given pre-operatively and are interrupted intraoperatively (Larsson et al 1990). Conversely, the risk of pre-operative hypoglycaemia has been demonstrated to be very low in normal healthy infants and children (1 to 2%), despite prolonged fasting periods (Jensen, Wemberg & Andersen 1982;Nilsson et al 1984;Payne & Ireland 1984;Srinivasan et al 1986;Welbornet al 1986Welbornet al ,1987Aun & Panesar 1990). There is, however, no agreement in the literature regarding ..…”

Section: Discussionmentioning

confidence: 99%

Evaluation of current paediatric guidelines for fluid therapy using two different dextrose hydrating solutions

Hongnat

Murat

Saint-Maurice

1991

Pediatric Anesthesia

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Summa ySimplified guidelines for intra-operative fluid therapy were evaluated in two groups of children (aged 3 months-10 years) undergoing minor non-haemorrhagic surgical procedures, randomly assigned to receive either 5% or 2.5% dextrose in 0.3% or 0.4% normal (N) saline. Blood samples were obtained at the time of induction and upon arrival in the recovery room. Fasting time was on average greater than 10 h and hypoglycaemia, defined as blood glucose less than 3.5 mmol-1-l, was observed in 7.4% of the children at the time of induction. In both groups, blood glucose increased at the end of surgery, this increase being more significant in children receiving 5% dextrose than in those receiving 2.5% dextrose. In both groups, post-operative blood glucose values were higher in children of less than 4 years of age than in those aged 4 and over. Blood glucose changes were associated with a decrease in plasma sodium, this decrease being greater in chiIdren receiving 5% dextrose in 0.3 N saline, especially in those less than 4 years of age. This study suggests that the use of a 5% dextrose hydrating solution in 0.3 N saline is more likely to result in hyperglycaemia and hyponatraemia than a 2.5% dextrose in a 0.4 N saline, particularly in children younger than 4 years of age.

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Preoperative Starvation and Blood Glucose Concentrations in Children Undergoing Inpatient and Outpatient Anaesthesia

Cited by 15 publications

References 0 publications

Effect of minimizing preoperative fasting on perioperative blood glucose homeostasis in children

Effect of minimizing preoperative fasting on perioperative blood glucose homeostasis in children

Fasting plasma glucose levels in healthy preschool children: effects of weight and lifestyle

Evaluation of current paediatric guidelines for fluid therapy using two different dextrose hydrating solutions

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