Randomized trial comparing overnight preoperative fasting period Vs oral administration of apple juice at 06:00–06:30 <scp>am</scp> in pediatric orthopedic surgical patients

Castillo‐Zamora, Carlos; Castillo-Peralta, Luz A; Nava-Ocampo, Alejandro A

doi:10.1111/j.1460-9592.2005.01517.x

Cited by 52 publications

(55 citation statements)

References 11 publications

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“…Moreover, it possibly causes disturbances in the fluid balance, which is a poor base for induction, and may even slow down recovery [37]. On the other hand, several studies have shown shorter fasting guidelines to be safe and beneficial [38,31,15,32]. Changes in the practice have been delayed mainly because of fear of aspiration of the gastric contents [31].…”

Section: Discussionmentioning

confidence: 99%

“…Changes in the practice have been delayed mainly because of fear of aspiration of the gastric contents [31]. When employing new fasting guidelines, neither aspiration nor other complications related to the fasting time have increased, and the patients have been more satisfied [38,32]. Previous research has shown that children undergoing tonsillectomy/adenotonsillectomy suffer from significant postoperative pain, nausea and vomiting [1,4].…”

Section: Discussionmentioning

confidence: 99%

“…Clear juices without pulp or visible chunks were allowed. Portions were calculated according to the child's weight, 10 ml/kg [34,31,32,35]. The child was not forced to drink more than he/she wanted.…”

Section: Intervention and Control Groupmentioning

confidence: 99%

“…Children have been allowed to drink clear fluids 2 h [31] and eat solids 4-6 h before surgery [15]. However, children are still often fasting preoperatively for longer periods in spite of the changed guidelines [32,33]. If it is possible to influence a child's postoperative well-being by counseling about proper preoperative nutrition, it is worth closer examination.…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

The effect of preoperative fasting on postoperative pain, nausea and vomiting in pediatric ambulatory tonsillectomy

Klemetti

Kinnunen

Suominen

et al. 2009

International Journal of Pediatric Otorhinolaryngology

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Intervention and Control Groupmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

The effect of preoperative fasting on postoperative pain, nausea and vomiting in pediatric ambulatory tonsillectomy

Klemetti

Kinnunen

Suominen

et al. 2009

International Journal of Pediatric Otorhinolaryngology

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“…[5][6][7][8] Óþarflega löng fasta hefur margvísleg neikvaeð áhrif á líkamsstarfsemi og líðan skurðsjúklinga, og eru þorsti, höfuðverkur, hungurtilfinning, þreyta, kvíðatilfinning, sljóleiki og svimi þekkt einkenni. 4,9,10 Löng fasta veldur einnig þurrki, insúlínónaemi, vöðva-rýrnun og veikir ónaemissvörun. 4,11 Rannsóknir sýna að neysla kolvetnaríkra drykkja tveimur til þremur klukkustundum fyrir aðgerð sé örugg, hún minnki Inngangur: Fasta sjúklinga er mikilvaeg öryggisráðstöfun fyrir skurðað-gerð.…”

Section: Inngangurunclassified

Fasta á undan skurðaðgerð: Leiðbeiningar til sjúklinga og lengd föstu – framskyggn könnun

Ingadóttir¹,

Ólafsdóttir²,

Sveinsdóttir³

et al. 2016

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Reevaluating Fasting for Procedural Sedation

2018

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Procedural sedation is widely administered by a variety of practitioners to facilitate painful or frightening procedures in children. [1][2][3][4][5][6][7][8][9] Guidelines 9 recommend a minimum period of fasting (nothing by mouth) prior to elective sedation because of concerns about pulmonary aspiration. [7][8][9] These guidelines most commonly mirror thresholds fixed for elective general anesthesia: 2 hours or longer for clear liquids, 4 hours or longer for breast milk, and 6 hours or longer prior for cow milk, infant formula, or a light meal. 9 Compliance with these requirements-whether for procedural sedation or for general anesthesia-comes at a cost to the child, the family, and to health care delivery. Fasting can be uncomfortable and distressing, 10 can cause dehydration 10 and hypoglycemia, 11 and is associated with decreased sedation efficacy 12 and more frequent sedation failure. 13 In clinical practice, it is common for minimum fasting durations to be substantially exceeded. 14 To minimize the potential for misunderstanding, patients may be intentionally instructed to fast longer, because an instruction of "nothing by mouth after midnight" is less complicated and error prone than separate thresholds for light meals vs breast milk vs clear fluids. Delays in starting scheduled procedures further extend fasting times. 14,15 Children with fasting violations risk lengthy procedure postponement or cancellation.The emergency department (ED) provides an ideal setting to scientifically evaluate the impact of fasting, because restricting oral intake after midnight cannot apply to patients requiring sedation for emergent and urgent procedures. On a daily basis, children in the ED require procedures (eg, laceration repair, abscess drainage, fracture and dislocation reduction, and diagnostic imaging) that must be promptly performed despite noncompliance with elective fasting guidelines. [2][3][4][5][6][7][8] Despite such regular ongoing performance of nonfasted sedation over decades, the ED has not been identified as a setting at greater risk for aspiration. [1][2][3]7,8 In this issue of JAMA Pediatrics, Bhatt et al 3 studied fasting guideline noncompliance for ED procedural sedation. In their multicenter, prospective, observational study, most children (3284 of 6183) receiving procedural sedation were noncompliant with standard elective fasting guidelines (vs 2899 who complied with fasting guidelines for solids and liquids) 9 and, despite this, were no more likely to vomit or experience other adverse events. No aspiration was observed in any child, whether compliant or noncompliant with fasting. These findings confirm multiple similar but smaller prior ED studies in the last 15 years 4-6 and a study including an ED subset. 1 The ED experience thus has consis-

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Randomized trial comparing overnight preoperative fasting period Vs oral administration of apple juice at 06:00–06:30 am in pediatric orthopedic surgical patients

Abstract: A 15 ml.kg(-1) of apple juice for patients of <3 years of age or 10 ml.kg(-1) for older children, at 06:00-06:30 am of the surgical morning is a simple procedure to prevent dehydration and to produce positive behavior in low-risk, pediatric surgical patients.

Cited by 52 publications

References 11 publications

The effect of preoperative fasting on postoperative pain, nausea and vomiting in pediatric ambulatory tonsillectomy

The effect of preoperative fasting on postoperative pain, nausea and vomiting in pediatric ambulatory tonsillectomy

Fasta á undan skurðaðgerð: Leiðbeiningar til sjúklinga og lengd föstu – framskyggn könnun

Reevaluating Fasting for Procedural Sedation

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