A prospective, Cross-sectional Survey of Pre- Operative Fasting of Pediatric Surgical Patients in a University Hospital. | [Anaesthesia, Pain and Intensive Care • 2016]

Author(s):

1. NoumanI Alvi: Department of Anesthesia & Pain Medicine, Aga Khan University Hospital, Karachi, Pakistan

Abstract:

Background: Fasting of children before anesthesia is mandatory but blighted with logistical issues. There may be inadvertent prolonged fasting due to lack of individualized fasting plans for children coming for surgeries. We aimed to have a survey of state of preoperative fasting in our pediatric patients. Methodology: A questionnaire based, prospective, cross-sectional survey was conducted in our Department for one month. A total of 102 children, up to age of 16 scheduled for pediatric surgery were included in the data collection. The questionnaires were to be filled either by anesthesia consultant or trainees. The information related to duration of fasting and any extra oral hydration, was attained from patients' parents/guardians. The duration of fasting was then compared with the recommended one. Results: In this study only 4% of children could be labelled as having the optimum fasting. Based on the current guidelines, in 96% of children, the guidelines were not followed. Conclusion: Pediatric patients are being subjected to prolonged durations of fasting prior to anesthesia and surgery against the accepted norms and the guidelines. Citation: Alvi NI. A prospective, cross-sectional survey of pre-operative fasting of pediatric surgical patients in a university hospital

Page(s): 171-175

DOI: DOI not available

Published: Journal: Anaesthesia, Pain and Intensive Care, Volume: 20, Issue: 2, Year: 2016

Keywords:

Fasting , Pediatric , Duration , Hydration

References:

[1] 2012.,Opin Anaesthesiol 25 315 -20

[2] .,doi: 10 -

[3] Anaesthesia, 1995., 50 458 -60

[4] Rev. 2009, .Oct 7;(4):CD005285, -

[5] ., -

[6] 2003.elective surgery,Anesth Analg -

[7] Apr, ., 96 965 -9

[8] 2007.infusions to children,NPSA 22 1 -

[9] ., -

[10] MandhanP,ShahA,KhanAW, 2000.Outpatient pediatric surgery in a developing country,J Pak Med Assoc 50 220 -4

[11] ShahM,HaqTU,AkhtarT., 1990.The effect of pre-anaesthetic fasting on blood glucose level in children undergoing surgery,J Pak Med Assoc 40 243 -5

[12] KannanL,LodhaR,VivekanandhanS,BaggaA,KabraSK,KabraM., 2010.Intravenous lfuid regimen and hyponatraemia among children: a randomized controlled trial,Pediatr Nephrol 10 2303 -9

[13] American, 2011.Society of Anesthesiologists committee on standards and practice parameters. Practice guidelines for preoperative fasting and the use of pharmacologic agents to reduce the risk of pulmonary aspiration: Application to healthy patients undergoing elective procedures,An updated report. Anesthesiology 114 495 -511

[14] SaqrL,ChambersWA, .Preventing excessive pre-operative fasting: national guideline or local protocol?,Anaesthesia 61 1 -3

[15] ArunBG,KorulaG, 2013.Preoperative fasting in children: An audit and its implications in a tertiary care hospital,J Anaesthesiol Clin Pharmacol 10 105810 -9185

[16] AduduOP,EgwakhideEOA,AduduOG, 2008.Parents and patients' compliance to revised preoperative fasting guidelines in Benin, Nigeria,Paediatr Anaesth 02607 9592 -4

[17] PollachG,KapendaR,AnusaB,WaluzaE,NamboyaF, 2014.Excessive fasting times: still an underaddressed challenge for African pediatrics and anesthesia? J Ped H Med Ther,April 5 9 -13

[18] EmersonBM,WrigleySR,NewtonM, .Pre-operative fasting for paediatric anaesthesia A survey of current practice,Anaesthesia 53 326 -30

[19] SplinterWM,StewartJA,MuirJG, 1990.Large volumes of apple juice preoperatively do not affect gastric fluid pH and volume in children,Can J Anaesth 37 36 -9

[20] SplinterWM,SchaeferJD,ZunderIH, 1990.Clear fluids three hours before surgery does not affect the gastric fluid contents of children,Can J Anaesth 37 498 -501

[21] BatesJ, .Reducing fast times in paediatric day surgery,1994 Nov 30-Dec 6 38 -9

[22] KlemettiS,SuominenT., 2007.Fasting in paediatric ambulatory surgery,Int J Nurs. Pract 00666 1440 -172X

[23] MuratI,DuboisMC, 2008.Perioperative fluid therapy in pediatrics,Paediatr Anaesth 02505 9592 -70

[24] KlemettiS,KinnunenI,SuominenT,AntilaH,VahlbergT,GrenmanR, 2008.The effect of preoperative fasting on postoperative pain, nausea and vomiting in pediatric ambulatory tonsillectomy,Int J Pediatr Otorhinolaryngol 10 263 -73

[25] RadkeOC,BiedlerA,KolodzieK,CakmakkayaOS,SilomonM,ApfelCC, 2009.The effect of postoperative fasting on vomiting in children and their assessment of pain,Paediatr Anaesth 02974 9592 -9

[26] EngelhardtT,WilsonG,HorneL,WeissM,SchmitzA, 2011.Are you hungry? Are you thirsty?--fasting times in elective outpatient pediatric patients,Paediatr Anaesth 03573 9592 -8

[27] Cook-SatherSD,LitmanRS, 2006.Modern fasting guidelines in children,Best Pract Res Clin Anaesthesiol 20 471 -81

[28] PhillipsS,DabornAK,HatchDJ, .Preoperative fasting for paediatric anaesthesia,Br J Anaesth1994; 73 529 -36

[29] SmithI,KrankeP,MuratI,SmithAF,O'SullivanG,SøreideE, 2011.Perioperative Fasting in Adults and Children: Guidelines from the European Society of Anaesthesiology,Eur J Anaesthesiol 10 556 -69

[30] CotéCJ,WilsonS, .Guidelines for monitoring and management of pediatric patients during and after sedation for diagnostic and therapeutic procedures: an update,Pediatrics 118 2587 -602

[31] 2016.Pediatric Anesthesia NPO Guidelines [Internet],Icahn School of Medicine at Mount Sinai. [Accessed June 1 -

[32] 2016.org/johns-hopkinschildrens-center/patients-and-families/ your-visit/abcs-surgery/adolescents,[Accessed June 1 -

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