The Impact of Preoperative Fasting Duration on Blood Glucose and Hemodynamics in Children

Abstract

Background. Prolonged preoperative fasting is one of the concerns of pediatricians and anesthesiologists in pediatric surgery. The aim of this study was to assess the impact of preoperative fasting duration on blood glucose and hemodynamics in children. Methods. This cross-sectional study was conducted on 50 children who were between the ages of 3 and 12 years in Besat Hospital, Hamedan, Iran. The time of the last solid and liquid meal taken by child were recorded based on interview with the parents. The first blood glucose test was obtained in the operation room, and the second test was performed 20 minutes after induction of anesthesia by glucometer. Systolic blood pressure (SBP), mean arterial pressure (MAP), and heart rate (HR) were recorded before anesthesia induction and in five-minute intervals in the first 20 minutes of surgery. Results. The mean age of the children was 6.63 (SD 1.85) years. Mean blood glucose 20 minutes after surgery was 101.17 (SD 92) mg/dl, which was significantly higher than the baseline values (87.66 (SD 11.84) mg/dl) (P<0.001). The comparison of mean blood glucose level between groups of fasting with different duration for solids (<12 hours and >12 hours) and for liquids (<6 hours and >6 hours) revealed no significant difference in either groups (P>0.05). No significant correlation was observed between blood glucose level at the induction of anesthesia with weight and age (P>0.05). There was a significantly negative correlation between duration of fasting for liquids and SBP (P>0.05). Conclusion. Prolonged preoperative fasting cannot affect blood glucose in children; however, maybe it has impact on systolic blood pressure.

Comparative Study of Children's' Blood Sugar in Fluid Therapy with Dextrose Saline, Ringer and Normal Saline 0.9% Serums and its Relationship with Depth of Anesthesia in Elective Surgery

“…This researcher found that children who were not allowed to drink fluids for more than 6 hours had lower blood pressure. [26], which is not consistent with the results of the present study. Prolonged fasting can be associated with hypotension [27].…”

“…The result of metabolic changes caused by endocrine changes is a large increase in plasma glucose concentration that occurs during surgery [35]. Some researchers have linked high blood sugar to peripheral insulin resistance, decreased insulin secretion, or impaired insulin metabolism, and others have considered high blood sugar as a defense mechanism to meet the need for glucose in tissues, saving energy and improve intravascular volume by increasing osmolarity [26]. On the other hand, a study by Verhoeven et.al, which was conducted to evaluate impaired glucose homeostasis after pediatric heart surgery, showed that 65% of children were prescribed glucocorticoids during surgery, this was the main factor associated with high blood sugar at the end of surgery [8].…”

Comparative Study of Children's' Blood Sugar in Fluid Therapy with Dextrose Saline, Ringer and Normal Saline 9.0% Serums and its Relationship with Depth of Anesthesia in Elective Surgery

“…Consistent with the results of the present study, the study of Jiménez et.al, showed that there was a statistically signi cant relationship between intraoperative blood sugar and other variables such as heart rate, oxygen saturation percentage and the respiration rate during the operation (27). On the other hand, the results of the study of Hajian et.al showed that fasting of children have no effect on their blood sugar but can reduce systolic blood pressure (28), which is not consistent with the results of the present study.…”

“…The result of metabolic changes caused by endocrine changes is a large increase in plasma glucose concentration that occurs during surgery (33). Some researchers have linked high blood sugar to peripheral insulin resistance, decreased insulin secretion, or impaired insulin metabolism, and others have considered high blood sugar as a defense mechanism to meet the need for glucose in tissues, saving energy and improve intravascular volume by increasing osmolarity (28). On the other hand, a study by Verhoeven et.al, which was conducted to evaluate impaired glucose homeostasis after pediatric heart surgery, showed that 65% of children were prescribed glucocorticoids during surgery, this was the main factor associated with high blood sugar at the end of surgery (7).…”

Preoperative Fasting Time and Its Association with Hypoglycemia during Anesthesia in Pediatric Patients Undergoing Elective Procedures at Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia

“…In this study, the mean glucose level of patients at the end of surgery is 134.18 mg/dl (SD = 71:15). This is higher than a study conducted in Iran in which the mean blood glucose level after surgery was 101.17 (SD = 92) [27]. In this study, none of the patients who took intraoperative glucose were found to be hypoglycemic at the end of surgery.…”