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Sedation in children: adequacy of two-hour fasting

K R Ingebo1, N J Rayhorn, R M Hecht

  • 1Department of Pediatric Gastroenterology, Phoenix Children's Hospital, Arizona 85006, USA.

The Journal of Pediatrics
|July 1, 1997
PubMed

Insights

Fasting longer than 2 hours after clear liquid intake does not significantly alter pediatric gastric volume or pH. Current fasting guidelines for procedures in children may not be effective in achieving desired gastric safety parameters.

Area of Science:

  • Pediatric Gastroenterology
  • Anesthesiology
  • Surgical Safety

Background:

  • Pediatric fasting guidelines aim to minimize aspiration risk during procedures.
  • Historical standards for gastric volume (<0.4 ml/kg) and pH (>2.5) are used to assess safety.
  • The relationship between fasting duration and these gastric parameters in children requires further investigation.

Purpose of the Study:

  • To examine the correlation between fasting duration and gastric volume and pH in pediatric patients.
  • To compare measured gastric parameters against established safety standards.

Main Methods:

  • 285 pediatric gastroscopies were performed on children aged 0.1 to 18.6 years.
  • Gastric contents were suctioned after sedation and analyzed for volume and pH.
  • Fasting durations ranged from 0.5 to 24 hours post-clear liquid ingestion.

Main Results:

  • No significant correlation was found between fasting duration and gastric volume (mean 0.68 ± 1.31 ml/kg) or pH (mean 2.03 ± 1.40).
  • Fasting times of 2 hours or longer did not significantly impact gastric volume or pH.
  • Fewer than half of patients achieved target gastric volume and pH, irrespective of fasting duration.

Conclusions:

  • Fasting for over 2 hours after clear liquid ingestion offers no significant benefit in altering pediatric gastric volume or pH.
  • Current pediatric fasting protocols may not effectively reduce aspiration risk.
  • Achieving "desirable" gastric safety parameters (volume ≤0.4 ml/kg, pH ≥2.5) is challenging in pediatric patients regardless of fasting duration.
Abstract

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