2023 American Society of Anesthesiologists Practice Guidelines for Preoperative Fasting: Carbohydrate-containing Clear Liquids with or without Protein, Chewing Gum, and Pediatric Fasting Duration—A Modular Update of the 2017 American Society of Anesthesiologists Practice Guidelines for Preoperative Fasting

Joshi, Girish P.; Abdelmalak, Basem; Weigel, Wade; Harbell, Monica W.; Kuo, Catherine I; Soriano, Sulpicio G.; Stricker, Paul A.; Tipton, Tommie; Grant, Mark D; Marbella, Anne; Agarkar, Madhulika; Blanck, Jaime Friel; Domino, Karen B.

doi:10.1097/aln.0000000000004381

Cited by 77 publications

(80 citation statements)

References 181 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…According to the updated 2023 ASA guidelines on fasting, include the use of oral midazolam, it is recommended to minimize fasting duration in children. Therefore, every effort should be made to permit clear liquids in healthy children up to 2 h before medical procedures ( 113 ), and that early eating is safe as long as the patients have recovered from anesthesia and swallowing function evaluation is done ( 114 ). It’s important to note that following the ASA fasting guidelines is recommended for patients undergoing moderate sedation, where the child may not be able to maintain verbal contact or may undergo deep sedation.…”

Section: Fastingmentioning

confidence: 99%

Procedural sedation in pediatric dentistry: a narrative review

Gao

2023

Front. Med.

View full text Add to dashboard Cite

Procedural sedation and analgesia are now considered standard care for managing pain and anxiety in pediatric dental patients undergoing diagnostic and therapeutic procedures outside of the operating room. Anxiolysis, which combines both pharmacologic and non-pharmacologic approaches, plays a significant role in procedural sedation. Non-pharmacologic interventions such as Behavior Management Technology can help reduce preprocedural agitation, ease the transition to sedation, reduce the required amount of medication for effective sedation, and decrease the occurrence of adverse events. As the introduction of novel sedative regimen and methods in pediatric dentistry, the potential role of mainstay sedatives administered by new routes, for new indications, and with new delivery techniques, should be considered. The purpose of this paper is to examine and discuss the current state of sedation techniques in pediatric dentistry.

show abstract

Section: Fastingmentioning

confidence: 99%

Procedural sedation in pediatric dentistry: a narrative review

Gao

2023

Front. Med.

View full text Add to dashboard Cite

show abstract

“…Second, positive fluid balance worsens the patient's outcome (3,106). In addition, patients are assumed to become fluid deficient before surgery, due to the classic and common practice of nil by mouth after midnight, despite strong recommendations (107). Therefore, fluid responsiveness should be assessed before initiating volume expansion in patients with hemodynamic instability (108).…”

Section: Hypotension Prediction Index: Internal and External Validationmentioning

confidence: 99%

Hypotension prediction index: From reactive to predictive hemodynamic management, the key to maintaining hemodynamic stability

Ripollés‐Melchor

Ruiz-Escobar

Fernández-Valdes-Bango

et al. 2023

Front. Anesthesiol.

View full text Add to dashboard Cite

Intraoperative hypotension is common and has been associated with adverse events, including acute kidney failure, myocardial infarction, and stroke. Since blood pressure is a multidimensional and measurable variable, artificial intelligence and machine learning have been used to predict it. To date, studies have shown that the prediction and prevention of hypotension can reduce the incidence of hypotension. This review describes the development and evaluation of an artificial intelligence predictive algorithm called Hypotension Prediction (HPI), which can predict hypotension up to 15 min before it occurs.

show abstract

“…In recent 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, focusing on intake of clear fluids containing carbohydrates (CHO) with or without protein, chewing gum, and duration of pediatric fasting. 2 Unfortunately, the abbreviation of fasting in elderly hip fracture patients was not addressed. The guidelines recommend that healthy adults drink CHO containing clear liquids up to 2 hours before elective procedures are submitted to general anesthesia, regional anesthesia, or sedation, and CHO can be simple or complex.…”

Section: Introductionmentioning

confidence: 99%

“…The guidelines recommend that healthy adults drink CHO containing clear liquids up to 2 hours before elective procedures are submitted to general anesthesia, regional anesthesia, or sedation, and CHO can be simple or complex. 2 The Brazilian Institute of Geography and Statistics (IBGE) showed in the 2022 Census 16.7% of elderly people, which is currently around 28 million elderly people in Brazil and should reach 32 million by 2025. 3 Studying from 2010 to 2014 in SUS patients in the state of Paraná, Brazil, 11,226 femur fractures were registered, 66.8% in women and 33.2% in men, concluding that fractures have a high incidence in the elderly and a large economic impact.…”

Section: Introductionmentioning

confidence: 99%

Importance of fasting abbreviation and analgesia in the satisfaction and recovery of elderly patients with hip and femur fractures. retrospective study with 1,001 patients

Imbelloni¹,

Ventura²,

Brasileiro³

et al. 2023

JACCOA

View full text Add to dashboard Cite

Background and objectives: There are several ways to assess patient satisfaction, as it is a standard indicator of the quality of care provided. The aim of this study was to evaluate whether the abbreviation of fasting with 200 ml CHO, the intake of the same beverage in the PACU, the return to oral feeding in the ward, and postoperative analgesia can improve comfort and satisfaction with anesthesia in elderly patients. with hip and femur fracture. Methods: A retrospective trial carried out in a Brazilian public health hospital (SUS), with 1,001 patients physical status ASA I-III submitted to hip and femur fracture surgery. The following items were evaluated: preoperative fasting time, evaluation of thirst and hunger upon arrival in the operating room, time of CHO administration in the PACU, time of reintroduction of oral feeding in the ward, and at this moment, the degree of satisfaction with the anesthetic conduct, abbreviation of fasting and early feeding. A satisfaction assessment was performed with YES and NO answers regarding the pre-anesthetic visit, the fasting abbreviation, the use of CHO in PACU, refeeding in the ward, and postoperative analgesia. Family members were also asked to return immediately to the ward, without intravenous hydration and without going through the ICU. Results: All patients had the fasting abbreviation between 1:20 h and 4:00 h. None of the 1,001 patients reported being thirsty when they arrived in the operating room, against only 26 patients reporting being hungry. The time of administration of dextrinomaltose in PACU ranged from 20 minutes to 5:45 h, and the reintroduction of oral feeding in the ward ranged from 4 h to 8:15 h. Analgesia with lumbar plexus block with a neurostimulator and levobupivacaine before or after providing mean analgesia of 22±4 h, with a minimum time of 13 h and a maximum of 34 h. All patients were able to be discharged from the hospital on the second postoperative day. Conclusion: This study with 1,001 patients clearly shows that in hospitalized elderly, the liberal use of CHO before surgery and immediately in PACU, and better quality analgesia is an easy and practical way to increase patient comfort and satisfaction with anesthesia care and with better outcomes.

show abstract

Cited by 77 publications

References 181 publications

Procedural sedation in pediatric dentistry: a narrative review

Procedural sedation in pediatric dentistry: a narrative review

Hypotension prediction index: From reactive to predictive hemodynamic management, the key to maintaining hemodynamic stability

Importance of fasting abbreviation and analgesia in the satisfaction and recovery of elderly patients with hip and femur fractures. retrospective study with 1,001 patients

Contact Info

Product

Resources

About