Preoperative fasting time and reasons for prolongation in pediatric patients undergoing elective surgery in Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia
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Date
2024-05
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Addis Ababa University
Abstract
Background: Preoperatively all patients, including pediatric patients are ordered to fast for a
specified duration in fear of perioperative aspiration. However, the risk of aspiration is recently
being reported to be minimal and the actual duration of fasting in these patients is longer than the
recommendations resulting in discomfort and possible metabolic derangements intraoperatively.
Methods: An institution-based prospective cross-sectional questionnaire-based study was
performed on 252 pediatric patients between the ages of 1 day to 12 years who are scheduled to
undergo elective surgery at Tikur Anbessa Specialized Hospital. The parents or caregivers were
asked the time and type of the last feeding of the child when the child came to the OR and further
information was gathered from the patient chart. Parent’s level of information about NPO times
and reasons behind any deviation from recommendation were also recorded. Data was collected
using interviews and descriptive analysis with mean and standard deviation used followed by
binary logistic regression used to identify associated factors in prolongation.
Results: Two hundred fifty-two participants were included. The mean and SD of actual fasting
times were 10.23 ±3.7 hours for clear fluids, 6.1±2.06 hours for breast milk and 12.39±2.8 hours
for light food. 92.3% of children had prolonged actual fasting times to clear fluids above 2 hours
from recommendation while its 40% and 81% when it comes to breastmilk and light food,
respectively. 30.2% of the parents blame inappropriate information and order delivered
preoperatively by the treating team as the cause for their child fasting longer. Age of the child,
and appropriateness of information delivered to the caregivers was found to significantly affect
actual fasting times of children.
Conclusion: Pediatric patients scheduled to undergo elective surgery are subjected to
unnecessarily prolonged fasting times above the recommendation put forth by ASA which is
found to be influenced by age of the child and appropriateness of information delivered to the
caregivers.
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Keywords
Preoperative, fasting time, Pediatric patients, Elective surgery