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

Abstract

Background: Preoperative fasting time for food and clear liquid was recommended as 2 and 6 h to prevent pulmonary aspiration. Prolonged fasting led to ketosis, hypotension, and patient discomfort. This study aimed to investigate the actual duration of preoperative fasting in pediatric patients, its effects on hunger and thirst, and factors that influence hunger and thirst.Methods: This prospective observational study recruited participants aged 0-15 years who were scheduled for elective surgery or for other procedures to be performed under general anesthesia in a tertiary care center. All parents or participants were asked to report the fasting time for food and clear liquid. Participants aged 7-15 years self-rated their degree of hunger and thirst using a 0-10 scale. For participants aged less than 7 years, parents were asked to rate their child's degree of hunger based on the child's behavior. Dextrosecontaining intravenous fluid administration and anesthesia start time were collected.Results: Three hundred and nine participants were included. The overall median [interquartile range; IQR] fasting duration for food and clear liquid was 11.

Preoperative clear fluids fasting times in children: retrospective analysis of actual times and complications after the implementation of 1-h clear fasting

“…Moreover, the significant association between adverse events and longer fasting times should encourage anesthesiologists, and in general all the perioperative health care personnel, to strictly adhere to the recommended guidelines to avoid excessive fasting times. Hypovolemia and/or dehydration in pediatric patients might lead to clinically significant adverse events [ 4 – 6 ]. Even if clinical consequences of dehydration were only partially and generically verified by our observations, and therefore likely underestimated, our study confirmed the findings reported by other studies [ 15 ].…”

“…Patients were considered compliant with the preoperative fasting protocol if clear fluids fasting time was between 60 and 119 min. The upper limit of this time range was chosen considering the old ESA preoperative fasting guidelines [ 9 ] recommending clear fluids until 2 h before the induction of anesthesia and being aware that preoperative clear fluids fasting times remain significantly longer than 120 min worldwide [ 4 , 7 ].…”

“…Furthermore, in case aspiration of clear fluids does occur, independently of the specific fasting regimen employed, clinical consequences are generally mild, usually requiring extended postoperative monitoring and, on occasion, short course of antibiotic therapy [ 1 ]. However, prolonged preoperative fasting is associated with children distress, alteration of glycemia, acid base and electrolyte balance, volemia, unpleasant feeling of thirst, and parents’ unsatisfaction [ 4 – 6 ]. Consequently, the European Society of Anaesthesiology and Intensive Care has recently recommended to reduce to 1-h preoperative clear fluid fasting time and to encourage patients to proactively drink up to this time [ 7 ].…”

The effect of preoperative fasting on the water sectors of the body in the perioperative period in children

“…В то же время в клинической практике продолжительность предоперационного голодания существенно превышает рекомендованное время. N. Aroonpruksakul et al (2023) продемонстрировали, что продолжительность отказа от твердой пищи и прозрачной жидкости составили 11,1 и 10,0 часов соответственно [5].…”

Perioperative Preparation of Patients Receiving GLP-1 Receptor Agonists

“…Оно будет лишь усугублять ситуацию развитием гипогликемии, обезвоживанием, развитием выраженного биохимического дисбаланса [12][13][14][15]. В этой связи важно, чтобы анестезиологи знали о данных обстоятельствах и были подготовлены для адекватной предоперационной подготовки и эффективного ведения таких пациентов.…”