[RECOMMENDATIONS FOR PERIOPERATIVE FASTING IN CHILDREN]

Area of Science:

• Pediatric Anesthesiology
• Surgical Patient Management
• Clinical Nutrition

Background:

• Perioperative fasting is a routine pre-surgical preparation for children.
• Current guidelines recommend clear liquids up to 2 hours, breast milk up to 4 hours, and solids up to 6 hours before surgery.
• Prolonged fasting is associated with adverse effects in pediatric patients, including those with cancer.

Purpose of the Study:

• To review current guidelines for perioperative fasting in children.
• To discuss the potential harms of prolonged fasting.
• To evaluate emerging evidence for liberalized perioperative approaches.

Main Methods:

• Review of existing literature and clinical guidelines on pediatric perioperative fasting.
• Analysis of the impact of fasting duration on pediatric surgical patients.
• Assessment of current evidence supporting changes to fasting protocols.

Main Results:

• The established "2-4-6" guideline (clear liquids 2h, breast milk 4h, solids 6h) remains the standard for pediatric perioperative fasting.
• Oral fluid intake is permitted within 3 hours post-surgery for most pediatric patients.
• While some studies suggest benefits of a more liberal approach, current evidence is insufficient to alter existing recommendations.

Conclusions:

• Adherence to current guidelines and proper planning can mitigate risks of prolonged perioperative fasting.
• Further research is needed to validate shorter fasting intervals.
• Future evidence may support modifications to current pediatric perioperative fasting guidelines.