Fasting Induced Hypoglycaemia in Anaesthetised Paediatric Patients

Inclusion Criteria: * All American Society of Anesthesiology score (ASA) 1 - 3 children aged 1 month to 18 years presenting for an elective procedure involving general anaesthesia during the defined study period * All elective cases, day cases will be included (patient's admitted the night before for bowel preparation prior to elective colonoscopy should also be included) * Planned expedited cases in ASA 1 / 2 children should be included, for example nail bed repairs, lacerations, foreign body (in ear / eye / nose), simple fractures for manipulation under anesthesia / k-wires * MRI, radiology and dental cases will be included provided the patient receives a general anaesthetic Exclusion Criteria: * Children aged less than 1 month * Procedures performed under oral sedation or local anaesthesia only * ASA status 4 and 5 * Children with any endocrine or metabolic condition or who have a fasting plan prior to general anaesthesia for glucose control: * Type 1 or 2 diabetes mellitus, medium chain acetyl Co-enzyme A, maple syrup urine disease, glycogen storage disease, galactosaemia, urea cycle defects, familial hypercholesterolaemia, congenital disorders of glycosylation, lysosomal storage disorders, organic acidaemias, mitochondrial disorders, adrenal gland disorders, adrenoleukodystrophy, growth disorders, lipid disorders, multiple endocrine neoplasia type 1 and 2, pituitary disorders. * Emergency and oncology procedures as these children will have different risk factors for hypoglycaemia * Anaesthetic involvement in critically ill children e.g. airway management in emergency department, pediatric intensive care unit * Children on glucose containing intravenous solutions or total parenteral nutrition pre-operatively * Children on systemic steroid treatment (oral / intravenous). Children on inhalers / topical steroids should be included