PREANAESTHETIC FASTING PRACTICE AND OUTCOME : A STUDY IN NEPALI CHILDREN

Abstract

The purpose of this study is to compare the outcome of traditionally advised pre-anesthetic fasted children
with those who fasted for lesser time in our setup.
One hundred and Sixty two children undergoing surgery under general anaesthesia were selected randomly.
They were divided into two groups. Group one was advised in a traditional way – no solid food after
midnight and no liquid drink at least six hours before anaesthesia. Group two was given either glucose
water 2-4 hours before induction or breast milk 4 hours before induction of anaesthesia. None of the children
were premedicated.
Anesthetic techniques were either sole intravenous anaesthesia (IVA) for minor cases or general anaesthesia
(GA) and combined methods (IVA or GA with regional blocks). Patients were closely monitored for any
active regurgitation and vomiting during the induction of anaesthesia, perioperative and postoperative
period. Complications were analyzed in different age groups, different fasting hours and type of anaesthesia
delivered.
None of the children had any regurgitation or vomiting during induction and perioperative period. Few
children of both groups vomited during postoperative period when they were fully conscious.
As the chances of regurgitation and vomiting with clear fluid given two hours before is comparable with the
traditional system, there is no need to put the child starved for prolonged period. This will avoid unnecessary
dehydration, hypoglycemia and uncoperation in the children.

Key Words: Pre-anaesthetic fasting, regurgitation, dehydration.