Safe pre-operative fasting times after milk or clear fluid in children. A preliminary study using real-time ultrasound.
Gastric emptying of orange-flavoured glucose (group I), low-fat milk (group II) and breast milk (group III) was evaluated in 45 ASA grade I children of < or = 5 years of age by using real-time ultrasonography and residual gastric volume and pH was then measured. In 15 more children, residual gastric volume and pH was measured after a midnight fast (group IV). Mean (SD) gastric emptying time in group I was 1.53 (0.25) h (range 1.00-1.75), group II 2.32 (0.31) h (range 1.75-2.75) and group III 2.43 (0.27) h (range 2.00-2.75). According to Robert and Shirley's criteria, no children of group I and II were found to be 'at risk' at 2 h and 3 h, respectively, but 13.3% of group III children were labelled as 'at risk' at 3 h. The incidence of 'at risk' children in group IV was 33.3%. It was concluded that 3% fat milk or 17.5% glucose in a volume of 10 ml.kg-1 (maximum volume of 100 ml) can be given in children safely 3 h and 2 h, respectively, before anaesthesia. More real-time studies are required on breast milk to establish guidelines for its potential use as a pre-operative feed 3 h before anaesthesia.
Sethi
A K
AK
Department of Anaesthesiology, University College of Medical Sciences & GTB Hospital, Delhi, India.
Chatterji
C
C
Bhargava
S K
SK
Narang
P
P
Tyagi
A
A
D000818:Animals; D002675:Child, Preschool; D005215:Fasting; D005746:Gastric Emptying; D005947:Glucose / Q000493:pharmacokinetics*; D006801:Humans; D007223:Infant; D008892:Milk / Q000378:metabolism*; D008895:Milk, Human / Q000378:metabolism; D011015:Pneumonia, Aspiration / Q000209:etiology; D011300:Preoperative Care / Q000379:methods*; D011706:Pyloric Antrum / Q000000981:diagnostic imaging / Q000378:metabolism; D012307:Risk Factors; D013997:Time Factors; D014463:Ultrasonography
D005947:Glucose