Preoperative fasting guidelines in pediatric anesthesia: are we ready for a change?

Purpose of review Study after study shows that prolonged fasting before anesthesia is common in children. Pediatric anesthesiologists around the world are concerned that the current guidelines may be part of the problem. This review focuses on what can be done about it. Recent findings We discuss new insights into the physiology of gastric emptying of different categories of food and drink. The evidence for negative effects of prolonged fasting occurring in spite of implementation of the current guidelines is examined. We also critically appraise the concept of a strict association between fasting time and the risk of aspiration and discuss recent studies in which children have been allowed clear fluids less than 2 h before anesthesia induction. Summary Accumulating evidence indicates that changes of the current guidelines for preoperative fasting should be considered for children undergoing elective procedures. Video abstract http://ift.tt/2srw2MV Correspondence to Peter Frykholm, Department of Surgical Sciences, Section of Anaesthesiology and Intensive Care Medicine, Uppsala University, 751 85 Uppsala, Sweden. Tel: +46 708454969; e-mail: Peter.Frykholm@surgsci.uu.se Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's Website (http://ift.tt/1qR4umk). Copyright © 2018 YEAR Wolters Kluwer Health, Inc. All rights reserved.

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