Preoperative Ultrasound Evaluation Of Gastric Volume After One Hour Of Ingestion Of Clear Liquid In Children : An Observational Study

Preoperative fasting is a cornerstone of paediatric anaesthesia practice primarily aimed at reducing the risk of pulmonary aspiration during general anaesthesia Traditionally children have been required to fast for extended periods before undergoing surgery often for 6 to 8 hours for solids and 2 to 4 hours for clear liquids However recent evidence suggests that such prolonged fasting protocols are not only unnecessary but can also result in adverse effects such as dehydration hypoglycaemia and increased discomfort for young patients As a result numerous paediatric anaesthesia societies including the European Society of Paediatric Anaesthesiology and the American Society of Anaesthesiologists have recommended a reduction in fasting times for clear liquids advocating for a fasting period of at least one hour for clear fluids in children Despite these revised guidelines there remains considerable debate regarding the safety and efficacy of this one hour fasting period The principal concern is whether gastric emptying occurs within one hour ensuring that there is minimal residual gastric content to pose a risk of aspiration during anaesthesia induction Previous studies evaluating gastric emptying in paediatric patients have primarily focused on solid foods and breast milk with less attention given to the clearance of clear liquids such as water juice and clear broths As such clinical evidence supporting the safety of a one hour fast for clear liquids in children is still limited and many clinicians remain cautious about reducing fasting times without stronger empirical backing Ultrasound has been shown to be an effective and reliable method for evaluating gastric emptying in paediatric patients with studies demonstrating its ability to accurately detect both solid and liquid contents The primary advantage of ultrasound over other techniques is its ability to provide immediate feedback on gastric status at the bedside without the need for specialized equipment or invasive procedures Additionally ultrasound offers the potential for repeated assessments to track gastric emptying over time making it particularly valuable in dynamic clinical situations such as preoperative evaluations