Impact of Actual Preoperative Fasting Duration on Blood Glucose, Hemodynamics, Child Thirst and Hunger Score in Pediatric Elective Surgery patients: A Prospective Observational Study

The current guidelines for preoperative fasting recommend intervals of 6, 4, and 2 h (6-4-2) of fasting for solids, breast milk, and clear fluids, respectively. The objective is to minimize the risk of pulmonary aspiration of gastric contents, but also to prevent unnecessarily long fasting intervals.However, despite these clear recommendations, fasting times are often prolonged both in India and globally.]Various factors contribute to non-compliance with guidelines, including organizational issues, communication problems, inadequate understanding of fasting instructions or necessity, intentional misinformation to avoid procedure cancellation, and conflicting instructions from multiple sources. Fasting leads to thirst, hunger and anxiety. Young children are used to eat more often than adults and it is also hard to explain to a small child why they cannot eat. Preoperative fasting may thus lead to additional anxiety and discomfort, in children already anxious because of the hospital environment and preoperative procedures. Not surprisingly, several studies show that children allowed to drink prior to surgery show less thirst, hunger and discomfort, than children that are kept fasting for longer periods.

Considering these studies and results, we planned to conduct a prospective observational study in pediatric population to evaluate actual preoperative fasting and its intraoperative pathophysiological effect.

In this study our aim is to evaluate the actual duration of preoperative fasting and its effect on blood glucose levels and hemodynamics in pediatric population age group 5 to 12 years undergoing elective surgical procedure under general anaesthesia.