Randomised controlled trial comparing preoperative carbohydrate loading with standard fasting in paediatric...

Area of Science:

• Anesthesiology
• Pediatric Surgery
• Gastroenterology

Background:

• Preoperative fasting in pediatric anesthesia causes discomfort and postoperative insulin resistance.
• Carbohydrate intake before surgery is not a well-established approach for children.
• Fasting can increase the inflammatory response to surgery in pediatric patients.

Purpose of the Study:

• To evaluate the effect of preoperative carbohydrate beverages on gastric content and perioperative discomfort in children.
• To compare standard preoperative fasting with carbohydrate loading in pediatric patients undergoing general anesthesia.
• To provide evidence for updated preoperative fasting guidelines in pediatric anesthesia.

Main Methods:

• 120 children undergoing gastroscopy under general anesthesia were randomized into two groups: standard fasting or carbohydrate beverage.
• Gastric content volume and pH were measured via endoscopic aspiration.
• Perioperative discomfort was assessed using pain scales and Visual Analog Scale (VAS), with blinded outcome evaluation.

Main Results:

• Carbohydrate loading resulted in significantly less gastric content compared to fasting (P=0.01).
• Fewer patients in the carbohydrate group experienced postoperative nausea (P=0.028), with no difference in vomiting.
• High preoperative VAS scores were less frequent in the carbohydrate group.

Conclusions:

• Preoperative carbohydrate intake effectively reduces gastric content, a key factor in preventing gastric aspiration.
• Carbohydrate loading can alleviate postoperative nausea in pediatric patients.
• This study contributes essential data for refining preoperative fasting protocols in pediatric anesthesia.