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Evidence summaries

Preoperative Fasting for Preventing Perioperative Complications in Children

Not permitting oral fluids for more than six hours preoperatively does not benefit normal risk children in terms of intraoperative gastric volume and pH as compared to children permitted unlimited fluids up to two hours preoperatively. Children permitted fluids have a more comfortable preoperative experience in terms of thirst and hunger. Level of evidence: "A"

A Cochrane review [Abstract] 1 included 47 studies with a total of 2543 children considered to be at normal risk of regurgitation or aspiration during anaesthesia. Only one incidence of aspiration and regurgitation was reported. Children permitted fluids up to 120 minutes preoperatively were not found to experience higher gastric volumes or lower gastric pH values than those who fasted. The children permitted fluids were also less thirsty and hungry, better behaved and more comfortable than those who fasted. Clear fluids preoperatively did not result in a clinically important difference in the children's gastric volume or pH. Evidence relating to the preoperative intake of milk was sparse. The volume of fluid permitted during the preoperative period did not appear to impact on children's intraoperative gastric volume or pH contents.

    References

    • Brady M, Kinn S, Ness V, O'Rourke K, Randhawa N, Stuart P. Preoperative fasting for preventing perioperative complications in children. Cochrane Database Syst Rev 2009;(4):CD005285. [PubMed]. [PubMed]

Primary/Secondary Keywords