[Preoperative fasting and fluid management in pediatric patients]

Area of Science:

• Anesthesiology
• Pediatric Surgery
• Nutritional Science

Context:

• Traditional preoperative fasting guidelines are being liberalized globally.
• Current guidelines permit clear fluids up to 2 hours and light meals up to 6 hours before anesthesia.
• Infant feeding recommendations allow breast milk up to 4 hours and other milk up to 6 hours.

Purpose:

• To summarize current evidence-based preoperative fasting guidelines for healthy children.
• To highlight the benefits of preoperative oral rehydration with carbohydrate-rich beverages.
• To define exclusion criteria and special considerations for high-risk patients.

Summary:

• Liberalized fasting guidelines recommend clear fluids up to 2 hours and light meals up to 6 hours before elective surgery.
• Preoperative oral rehydration with carbohydrate-rich fluids (up to 2 hours) may enhance hemodynamic stability, glucose homeostasis, and patient satisfaction.
• Guidelines are for healthy children; contraindications include obesity, diabetes, and gastrointestinal issues. Trauma and emergency cases require specific management due to aspiration risk.

Impact:

• Facilitates safer and more efficient anesthesia by minimizing aspiration risk.
• Improves patient experience through reduced dehydration, better hemodynamic stability, and increased satisfaction.
• Provides evidence-based recommendations for optimizing preoperative care in pediatric populations.