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Large volumes of apple juice preoperatively do not affect gastric pH and volume in children
W M Splinter1, J A Stewart, J G Muir
1Department of Anaesthesia, Izaak Walton Killam Hospital for Children, Dalhousie University, Halifax, Nova Scotia, Canada.
Insights
Giving children apple juice 2.5 hours before surgery does not affect gastric volume or pH. However, it can reduce thirst and irritability in pediatric patients before anesthesia.
Area of Science:
- Anesthesiology
- Pediatric Surgery
- Gastroenterology
Background:
- Fasting guidelines are crucial for pediatric surgery to minimize aspiration risk.
- Clear liquids are often permitted, but their effect on gastric contents needs evaluation.
- Apple juice is a common clear liquid choice for children.
Purpose of the Study:
- To investigate the impact of varying apple juice volumes on gastric pH and volume in children.
- To assess the effect of apple juice on pediatric patient comfort before anesthesia.
Main Methods:
- Prospective, randomized, single-blind study involving children aged 5-10 years.
- Three groups received 0, 6, or 10 ml/kg of apple juice 2.5 hours pre-surgery.
- Gastric contents were aspirated post-anesthesia induction for volume measurement and pH assessment.
Main Results:
- No significant differences in gastric volume or pH were observed among the groups.
- Average gastric volumes were 0.45, 0.66, and 0.71 ml/kg for 0, 6, and 10 ml/kg juice groups, respectively.
- Patients receiving 6 ml/kg apple juice reported significantly less thirst and irritability (P<0.05).
Conclusions:
- Clear apple juice administered 2.5 hours before surgery does not adversely affect gastric volume or pH in children.
- Apple juice may improve pediatric patient comfort, reducing thirst and preoperative distress.
- These findings support the use of clear apple juice as a preoperative beverage in pediatric surgical patients.
Abstract:
The effect on gastric pH and volume of 0, 6 and 10 ml.kg-1, of apple juice given 2.5 hours before surgery to children aged five to ten years was investigated in this prospective, randomized, single-blind study. Gastric contents were aspirated after induction of anaesthesia, and the volume measured. The pH of the gastric aspirate was then assessed using pH paper. Neither gastric volume nor pH immediately following the induction of general anaesthesia were significantly different among the three groups. Gastric volumes after 0, 6 and 10 ml.kg-1, of juice averaged (mean +/- SD) 0.45 +/- 0.31, 0.66 +/- 0.79 and 0.71 +/- 0.76 ml.kg-1, respectively; gastric pH averaged 1.7 +/- 0.6, 1.7 +/- 0.6 and 1.8 +/- 0.8, respectively. On the basis of questions asked immediately before induction of anaesthesia, patients who drank 6 ml.kg-1 of apple juice had decreased thirst and were less irritable and upset before anaesthesia than those who had not (P less than 0.05). It is concluded that drinking large volumes of clear apple juice 2.5 hours before scheduled surgery does not have a measurable effect on gastric volume and pH and may offer benefits such as improved patient comfort.