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[Effect of fasting and maintenance solutions on perioperative blood glucose in children]
Insights
Prolonged fasting increases hypoglycemia risk in children undergoing surgery. Ringer's lactate or a 2:1 mixture is recommended over glucose solutions to maintain stable blood sugar levels.
Area of Science:
- Pediatric Anesthesiology
- Metabolic Regulation
Background:
- Perioperative fasting guidelines are crucial for pediatric surgical patients.
- Maintaining stable glycemic control during anesthesia is essential.
Purpose of the Study:
- To evaluate the impact of fasting duration on preoperative glycemic levels in children.
- To compare the effects of different intravenous solutions on postoperative blood sugar levels.
Main Methods:
- A randomized study involving 90 pediatric patients.
- Blood glucose levels were measured pre-anesthesia, post-fasting, and post-operation.
- Patients received Ringer-lactate, 5% glucose, or a 2:1 mixed solution.
Main Results:
- Hypoglycemia occurred in 14.4% of cases, increasing with prolonged fasting.
- Group B (5% glucose) showed significant postoperative hyperglycemia.
- Ringer-lactate and the 2:1 mixture groups had no significant glycemic changes.
Conclusions:
- Fasting should not exceed 12 hours; prompt intravenous restitution is advised for longer periods.
- Ringer-lactate or a 2:1 mixture are recommended perioperative solutions to prevent glycemic extremes.
- Optimizing perioperative fluid management is key to pediatric glycemic control.
Abstract:
The effects of fasting on preoperative glycemic levels and the influence of different intravenous solutions on postoperative sugar levels are discussed. Sugar levels were determined in 90 children, randomly placed in three groups, (according to the solution they were administered-A: Ringer-lactate, B: glucose at 5%, C: mixed-2 x 1) at the time they entered the hospital, after fasting previous to the anesthetic induction, and in the immediate postoperative period. In 14.4% of the cases hypoglycemia was found during the anesthetic induction, increasing as the fasting period was prolonged. The postoperative hyperglycemia seen in Group B was important, the other groups showed no significant changes. We recommend that the fasting period be no longer than 12 hours and to immediately start intravenous restitution if this period is extended further. Also, only Ringer's lactate solution or a 2 to 1 mixture is recommended to be used during surgery in order to avoid preoperative hypoglycemia and postoperative hyperglycemia. Glycemia; fasting; perioperative solutions.