A Retrospective Study on Preoperative Fasting in Pediatric Population in a Tertiary Center

Abstract Background: Patients scheduled for elective procedures require appropriate fasting to prevent complications like aspiration. In children, it is important to avoid over-fasting. The primary objective of this study was to determine whether we adhered to the fasting guidelines of the American Society of Anesthesiologists (ASA). The secondary objectives included identifying the reasons for any deviations from these guidelines and assessing the impact of fasting on a child’s preoperative and postoperative behavior. Materials and Methods: We collected data on preoperative fasting in 263 children aged 1 month to 18 years who were scheduled for elective surgeries over a year. We recorded details regarding preoperative fasting hours for solids, breast milk, clear fluids, and water. In addition, we noted any delay in scheduled time, preoperative and postoperative behavior, signs of dehydration, premedication, reasons why parents chose to feed their children during the preoperative period, postoperative analgesia, feeding in recovery, and recovery times. Results: We were able to strictly and partially comply with ASA guidelines on fasting in 65.7%, 84.2%, and 91.2% of cases for water/clear juice, breast milk, and solids, respectively. Even though we prioritized the smallest babies at the top of the list, instances of prolonged fasting still occur due to many reasons. Prolonged fasting can lead to abnormal behavior in children both preoperatively (10.7%) and, possibly, postoperatively (12.3%). Conclusion: With proper planning and communication, we can adhere to standard preoperative fasting guidelines. Avoiding excessive fasting helps keep children comfortable during the preoperative and postoperative periods.