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Hanna Andersson1, Peter Frykholm2
1Akademiska sjukhuset - Institutionen för kirurgiska vetenskaper, Anestesi och Intensivvård Uppsala, Sweden - Institutionen för kirurgiska vetenskaper, Anestesi och intensivvård Uppsala, Sweden.
Insights
New European guidelines suggest reducing clear fluid fasting for children before surgery to 1 hour, down from 2 hours. This change aims to minimize negative impacts of prolonged fasting, though further research on aspiration risks is required.
Area of Science:
- Pediatric Anesthesiology
- Surgical Patient Care
Background:
- Current international guidelines recommend a 2-hour limit for clear fluid intake before elective pediatric surgery.
- Emerging evidence highlights concerns regarding prolonged preoperative fasting, including gastric emptying times and pulmonary aspiration risks.
Purpose of the Study:
- To present the European Society of Paediatric Anaesthesia's new consensus statement on preoperative fasting guidelines.
- To advocate for a revised 1-hour fasting limit for clear fluids in pediatric elective surgery.
Main Methods:
- Review of recent reports on gastric emptying and aspiration incidence.
- Development of a new consensus statement by the European Society of Paediatric Anaesthesia.
Main Results:
- A new consensus recommends a 1-hour fasting limit for clear fluids in pediatric elective surgery.
- This revised guideline addresses concerns about prolonged fasting's negative effects.
Conclusions:
- The European Society of Paediatric Anaesthesia proposes a shortened 1-hour clear fluid fasting period for pediatric elective procedures.
- Further multicentre audits are necessary to evaluate the incidence of aspiration with these updated fasting regimens.
Abstract:
International guidelines for paediatric elective preoperative fasting currently recommend a 2 hour limit for clear fluids. Recent reports on gastric emptying time, pulmonary aspiration incidence and the negative effects of fasting have led to a new consensus statement by the European Society of Paediatric Anaesthesia, recommending a 1-hour limit for clear fluids. A multicentre audit of the incidence of aspiration with the new fasting regimens is still needed.