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Metabolic and Inflammatory Benefits of Reducing Preoperative Fasting Time in Pediatric Surgery

Carlos Augusto Leite de Barros Carvalho1, Augusto Aurélio de Carvalho1, Antônio D'Oliveira Gonçalves Preza1

  • 1Santa Casa de Misericórdia de Cuiabá-MT, Cirurgia Pediátrica - Cuiabá - MT - Brasil.

Revista Do Colegio Brasileiro De Cirurgioes
|June 25, 2020
PubMed

Insights

Reducing preoperative fasting with carbohydrate-rich drinks in children significantly lowers inflammation and improves metabolic response. This approach enhances surgical outcomes without adverse events.

Area of Science:

  • Pediatric Surgery
  • Anesthesiology
  • Pediatric Metabolism

Background:

  • Prolonged preoperative fasting in children can lead to metabolic and inflammatory stress.
  • Optimizing perioperative nutrition is crucial for pediatric surgical patients.

Purpose of the Study:

  • To evaluate the metabolic and inflammatory effects of shortened preoperative fasting using carbohydrate-rich beverages in preschool children.
  • To assess the impact on key biomarkers and insulin resistance.

Main Methods:

  • A randomized controlled trial involving 40 preschool children undergoing inguinal hernia surgery.
  • Comparison between a standard fasting group and a group receiving a carbohydrate-rich beverage two hours before surgery.
  • Analysis of pre- and post-operative blood samples for albumin, interleukin-6, glucose, insulin, C-reactive protein (CRP), and HOMA-IR index.

Main Results:

  • The carbohydrate group had significantly shorter fasting times (2.49h vs. 11.24h).
  • Lower pre- and post-surgical CRP levels and preoperative CRP/albumin ratios were observed in the carbohydrate group.
  • Fewer hyperglycemic events occurred in the carbohydrate group (0% vs. 21%).
  • No significant differences in albumin, interleukin-6, insulin, or HOMA-IR were found between groups.

Conclusions:

  • Shortening preoperative fasting with carbohydrate-rich beverages positively impacts metabolic and inflammatory responses in pediatric surgical patients.
  • This strategy appears safe and effective in reducing perioperative stress markers.
  • The findings support revised fasting guidelines for preschool children undergoing elective surgery.
Abstract

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