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Preoperative fasting in paediatric anaesthesia: a movie with a predicable ending
1Unit for Research in Anaesthesia, IRCCS Istituto Giannina Gaslini, Genova, Italy.
Insights
The EUROFAST study found that allowing children to drink clear fluids for at least 1 hour before anesthesia is as safe as traditional longer fasting periods. This supports modernizing pediatric fasting guidelines for anesthesia.
Area of Science:
- Anesthesiology
- Pediatric Medicine
- Patient Safety
Background:
- Traditional fasting guidelines for pediatric anesthesia are often prolonged.
- Concerns exist regarding the safety and necessity of extended fasting periods.
- Modernizing fasting protocols can improve patient comfort and reduce dehydration.
Abstract:
A large international prospective pragmatic study (EUROFAST), analysing more than 306 900 anaesthetic procedures across 31 centres, compared the incidence of pulmonary aspiration in children after three different clear fluid fasting regimens: traditional fasting (≥2 h before induction of anaesthesia), ≥1 h fasting before induction and sip-til-send. EUROFAST provided further evidence supporting the safety of liberal fasting times by demonstrating that the incidence of confirmed pulmonary aspiration with fasting durations of ≥1 h is not higher than that observed with a ≥2 h fasting period. EUROFAST provided additional evidence to support changes in practice for institutions that still adhere to the outdated 6-4-2 fasting regimen by adopting a more modern approach of ≥1 h fasting or sip-til-send.
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