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Preoperative fasting in children

C S Aun1

  • 1Department of Anaesthesia and Intensive Care, Chinese University of Hong Kong, Shatin, New Territories.

Annals of the Academy of Medicine, Singapore
|July 1, 1994
PubMed
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New pediatric preoperative fasting guidelines allow clear fluids up to 2-3 hours before anesthesia, reducing thirst and irritability in healthy children. This practice does not increase aspiration risk, but vigilance is needed with laryngeal mask airways.

Area of Science:

  • Anesthesiology
  • Pediatric Surgery
  • Critical Care Medicine

Background:

  • Current pediatric preoperative fasting guidelines are based on outdated knowledge.
  • Aspiration pneumonitis is a significant risk in pediatric anesthesia, though actual incidence is low.
  • Healthy children have a high potential risk for aspiration (60-75%).

Purpose of the Study:

  • To review and update pediatric preoperative fasting guidelines.
  • To assess the safety and efficacy of allowing clear fluids up to 2-3 hours before anesthesia in children.
  • To provide clear instructions for parents regarding preoperative fasting.

Main Methods:

  • Review of current literature and recent investigations on pediatric preoperative fasting.
  • Comparison of aspiration risk between conventional fasting and allowing clear fluids.

Related Experiment Videos

  • Clinical judgment for identifying high-risk pediatric patients.

    • Main Results:

    • Allowing clear fluids up to 2-3 hours before anesthesia does not increase aspiration risk in healthy children.
    • Children are less thirsty and irritable with the updated fasting regimen.
    • Reduced incidence of hypoglycemia and hypovolemia in infants is possible.
    • Laryngeal mask airway (LMA) does not offer the same airway protection as an endotracheal tube.

    Conclusions:

    • Updated guidelines allowing clear fluids 2-3 hours before anesthesia are safe for healthy children.
    • Simple, explicit preoperative fasting instructions are beneficial for parents, especially in day-case settings.
    • Careful clinical assessment is crucial for identifying and managing high-risk pediatric patients.
    • Constant vigilance is required when using LMAs in children due to aspiration risks.