Comparison of different preoperative fasting times for pediatric elective surgical procedures: A randomized controlled trial

Objective: To compare the mean residual gastric volume and gastric pH with standard and liberal fasting in children undergoing general anesthesia for elective procedures. Methods: A randomized controlled trial (NCT 05922072) was conducted at Department of Pediatric Surgery, Mayo Hospital Lahore from June 2021 to December 2021 and 120 patients undergoing elective daycare surgical procedures under general anesthesia were enrolled. Patients were divided into Group-A (Standard fasting) and Group-B (Liberal fasting). Group-A with 6-, 4- and 2-hours Nil per oral (NPO) for solids/ formula milk, breast milk and clear fluid, while Group-B with six, four and one hour NPO for solids/ formula milk, breast milk and clear fluid respectively. Residual gastric volume and pH were measured after anesthetizing the patient. Effect modifiers like age, gender, duration of anesthesia and procedure were controlled through stratification. Post-stratification, t-test was applied and p-value less than 0.05 was taken as statistically significant. Results: In Group-A, mean age was 6.1±4.5 years and 6.4±4.6 years in Group-B. Mean residual gastric volume with standard fasting was 0.67±0.48 ml and liberal fasting 0.80±0.44 ml (p value 0.13). Mean gastric fluid pH with standard fasting was 1.72±0.78 as compared to liberal fasting 1.63±0.70 (p value 0.53). Conclusion: Free fluid fasting allows for significantly shorter fasting times, though statistically insignificant higher residual gastric volume was recorded in liberal fasting group with a lower pH. doi: https://doi.org/10.12669/pjms.40.7.8403 How to cite this: Jasarat H, Naumeri F. Comparison of different preoperative fasting times for pediatric elective surgical procedures: A randomized controlled trial. Pak J Med Sci. 2024;40(7):---------. doi: https://doi.org/10.12669/pjms.40.7.8403 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.