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Clear fluids three hours before surgery do not affect the gastric fluid contents of children
W M Splinter1, J D Schaefer, I H Zunder
1Department of Anaesthesia, Children's Hospital, University of Ottawa, Ontario.
Insights
Clear fluid intake up to three hours before surgery does not significantly alter gastric volume or pH in healthy children aged 2-12 years. This finding supports current guidelines for preoperative fluid fasting in pediatric patients.
Area of Science:
- Pediatric Anesthesiology
- Gastrointestinal Physiology
Background:
- Preoperative fasting guidelines aim to minimize aspiration risk.
- The impact of clear fluid intake on pediatric gastric contents requires clarification.
Purpose of the Study:
- To investigate the effect of clear fluids on gastric volume and pH in children.
- To determine if drinking clear fluids up to three hours before surgery impacts gastric contents.
Main Methods:
- Prospective, randomized, single-blind study.
- 121 healthy children aged 2 to 12 years.
- Measurement of gastric fluid volume and pH post-induction of general anesthesia.
Main Results:
- No significant difference in gastric fluid volume or pH between children who ingested clear fluids and those who fasted.
- Gastric fluid volume increased with age in both groups (P < 0.005).
- Mean gastric volume was 0.39 ± 0.37 ml/kg and pH was 1.7 ± 0.4 after prolonged fasting.
- Mean gastric volume was 0.34 ± 0.28 ml/kg and pH was 1.8 ± 0.7 after clear fluid intake.
Conclusions:
- Drinking clear fluids up to three hours before surgery does not measurably affect gastric volume and pH in healthy children.
- Findings support current recommendations for clear fluid intake in pediatric preoperative management.
- Age is a significant factor influencing gastric fluid volume in children.
Abstract:
This prospective, randomized, single-blind study of 121 healthy children aged 2 to 12 yr investigated the effect of clear fluids on gastric contents. Gastric fluid volume and pH were measured immediately following the induction of general anaesthesia and were not significantly affected by the ingestion of unlimited clear fluids up to three hours preoperatively. After a prolonged fast (mean fast 14 hr), gastric fluid volume was 0.39 +/- 0.37 ml.kg-1 and gastric pH was 1.7 +/- 0.4; after unlimited clear fluids (203 +/- 109 ml) up to three hours before surgery gastric fluid volume was 0.34 +/- 0.28 ml.kg-1 and gastric pH was 1.8 +/- 0.7 (mean +/- SD). Gastric fluid volume (ml.kg-1) increased in both the control and study groups as age increased, P less than 0.005. It is concluded that drinking clear fluid up to three hours before scheduled surgery does not have a measurable effect on gastric volume and pH of healthy children of ages 2 to 12 yr.