THURSDAY, June 14, 2018 — On the day of surgery it is practical to allow children to drink until one hour before anesthesia, according to a special interest article published online April 27 in Pediatric Anesthesia.
Mark Thomas, M.B.B.Chir., from the Great Ormond Street Hospital in London, and colleagues examined the impact of a liberalized clear fluid fasting regimen for elective pediatric general anesthesia.
The researchers found that, based on the literature, the traditional two-hour clear fluid fasting time can translate into an actual duration of fasting of six to seven hours, with some studies reporting up to 15 hours. Increased thirst and irritability are reported with prolonged fasting period, as well as detrimental physiological and metabolic effects. No increased risk of pulmonary aspiration was reported with a one-hour clear fluid policy and studies demonstrated that the stomach was empty. Less nausea, vomiting, thirst, hunger, and anxiety were reported with allowing a drink closer to surgery; in addition, children were more comfortable, better behaved, and possibly more compliant. Positive physiological and metabolic effects were reported in children younger than 36 months.
“Based on the current convincing evidence base, unless there is a clear contraindication, it is safe and recommended for all children able to take clear fluids, to be allowed and encouraged to have them up to one hour before elective general anesthesia,” the authors write.
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Posted: June 2018