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Fasting in children for day case surgery
1Department of Ear, Nose and Throat Surgery, Charing Cross Hospital, London.
Insights
Prolonged preoperative fasting in pediatric day surgery patients (88% fasted ≥12 hours) increases hypoglycemia risk. Mid-day surgery lists can shorten fasting times and reduce this risk.
Area of Science:
- Pediatric Anesthesiology
- Surgical Patient Care
Background:
- Preoperative fasting guidelines are crucial for pediatric day surgery.
- Prolonged fasting can lead to adverse metabolic outcomes like hypoglycemia.
- Current fasting practices in pediatric day surgery require evaluation.
Purpose of the Study:
- To assess preoperative fasting durations in children undergoing day case surgery.
- To measure blood glucose levels at anesthesia induction.
- To identify risks associated with current fasting protocols.
Main Methods:
- Observational study of 34 pediatric day case surgery patients.
- Data collection on preoperative fasting periods.
- Measurement of blood sugar concentrations prior to anesthesia.
Main Results:
- 88% of children fasted for 12 hours or longer.
- 20% of children fasted for 16 hours or longer.
- Three patients (9%) presented with hypoglycemia at anesthesia induction.
Conclusions:
- Current preoperative fasting practices for pediatric day surgery are excessively long.
- Extended fasting is linked to an increased risk of hypoglycemia.
- Implementing routine mid-day operating lists is recommended to mitigate fasting duration and hypoglycemia risk.
Abstract:
Thirty-four children admitted for day case surgery were studied to determine the period of preoperative fasting and blood sugar concentrations at the time of induction of anaesthesia. Of these, 88% fasted for 12 h or more, 20% fasted for 16 h or more. Three were found to be hypoglycaemic. The introduction of routine 'mid-day' operating lists for paediatric day case surgery is suggested as a method of reducing the period of fasting and risk of hypoglycaemia.