Preoperative Pediatric Fasting Regimens

Tanta University200 enrolled

Overview

The presence of gastric contents makes an aspiration event more likely , and as a result, preoperative fasting guidelines are designed to provide adequate time for gastric emptying in patients undergoing surgery. this study will be conducted to assess the gastric volume and content with the help of ultrasound in fasted pediatric patients scheduled for elective surgeries

it is unknown how many patients have gastric volumes that place them at increased risk of aspiration despite adequate fasting. There is a growing interest in the use of bedside ultrasonography to assess gastric content and volume. It has been suggested that the gastric antrum in particular can be assessed reliably by sonography. hence, this study will be conducted to assess the gastric volume and content with the help of ultrasound in fasted pediatric patients scheduled for elective surgeries which will help to detect accuracy of preoperative fasting hours.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

SCREENING

Masking

SINGLE

Enrollment

200

Conditions

Anesthesia

Interventions

liberal fastingOTHER

preoperative fasting according to 6-4-0 regimen then qualitative and quantitative preoperative gastric ultrasound assessment will be done to evaluate the proportion of patients with risky stomach

standard fastingOTHER

preoperative fasting according to 6-4-2 regimen then qualitative and quantitative preoperative gastric ultrasound assessment will be done to evaluate the proportion of patients with risky stomach

Eligibility

Sex: ALLMin age: 8 YearsMax age: 18 Years

Medical Language ↔ Plain English

Inclusion Criteria: * paediatric patients aged 6-12 years old * ASA physical status I and II * scheduled for elective surgeries * the anticipated duration of 30-60 min Exclusion Criteria: * parents' refusal * overweight or obesity * expected difficult airway management * increased abdominal pressure * diabetes mellitus * congenital diseases * GERD or esophageal disease * uncooperative patients, * mental retardation or neurological disease * upper airway surgeries.

Locations (1)

Tanta University, Faculty of Medicine

Tanta, Egypt

Outcomes

Primary Outcomes

proportion of patients with a risky stomach.

bedside ultrasound to estimate the gastric volume in milliliter

Time frame: immediately preoperative

Secondary Outcomes

gastric content quality

bedside ultrasound to determine the nature of gastric content (solid or fluid)

Time frame: immediately preoperative

fasting hours

actual and prescribed preoperative fasting

Time frame: the new preoperative fasting (6 hours for solids, 4 hours for milk, non-clear fluid or light breakfast, and 0 hours for clear fluids)

type of last meal

last meal (heavy solid,light solid,non clear fluid,or clear fluid)

Time frame: last meal within 24 hours preoperative

episodes of gastric regurgitation, vomiting , aspiration

incidence of regurgitation, vomiting , aspiration if regurgitation happened patients will be followed up postoperative clinically and radiologically

Time frame: during induction or emergence from anesthesia (within 30 minutes)

gastric volume

quantitative gastric ultrasound assessment (gastric volume, volume/weight, antral cross sectional area)

Time frame: immediately preoperative (within 30 minutes)

parents satisfaction

parents' satisfaction is evaluated using a 5-point Likert scale

Time frame: after PACU discharge (within 2 hours postoperative)

Data from ClinicalTrials.gov

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