Patients are required to abstain from food and drink before surgery. In younger patients the resulting fast of 6 to 18 hours leads to thirsty, hungry and irritable children. 1.2 In order to minimize these discomforts, the optimum length for this fast must be established.Previous studies have demonstrated the safety and efficacy of administering specific volumes (2-10 ml. kg-i) and types (water, apple juice, five per cent dextrose water and 20 per cent Poly-Joule) of clear fluids to children two to three hours before surgery. 1-5 This study of healthy children compared the effect of an overnight fast with the effect of permitting unlimited clear fluids up to three hours before surgery on gastric fluid volume and pH.
MethodsThis study was approved by the Hospital Ethics Committee and parental consent was obtained. Patients were excluded from the study if there was a history of gastrointestinal disease or if the patient was receiving medication known to affect gastric contents.One hundred and twenty-one healthy children aged 2-12 yr scheduled for elective surgery were randomly assigned to one of two groups. Children in Group A fasted from midnight. Children in Group B did not consume solid food on the day of their operation but were instructed to ingest unlimited volumes and types of clear fluids up to three hours before their scheduled surgery. For the purpose of this study clear fluids were defined as aqueous solutions, which are liquids at 37 ~ C. 6'7 Non-clear fluids, suspensions and emulsions, such as milk and most broths, were not permitted. Parents or nursing staff were asked to monitor accurately the amount of fluid ingested on the day of surgery.