WOFAPS 2025 8th World Congress of Pediatric Surgery

Yeşim Andıran Şenaylı ¹, Cevdet Yardımcı ², Mehmet Kara ², Mustafa Furkan Karatekin ², Sevgi Ulusoy Tangül ³, Atilla Şenaylı ³

¹ Kırklareli University, School of Medicine, Department of Anesthesiology and Reanimation
² Bozok University, Faculty Of Medicine, Department Of Anesthesiology Yozgat,Turkey
³ Kırklareli University, School of Medicine, Department of Pediatric Surgery

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Despite recommended preoperative fasting durations in children, prolonged fasting is often observed in clinical practice, leading to potential complications including hypotension, ketosis, and patient dissatisfaction.

This cross-sectional observational study aimed to evaluate actual preoperative fasting durations in pediatric elective surgeries, identify discrepancies from guidelines, and explore underlying reasons for these discrepancies. Additionally, perioperative vital signs and hemodynamic parameters were monitored to assess potential clinical effects.

Methods:
Conducted between December 2023 and December 2024 at Yozgat Bozok University the study included 124 pediatric patients (aged 43 days–18 years) undergoing elective surgeries. Data on fasting durations were collected via interviews with patients&caregivers, anesthesia monitoring was utilized to assess vital signs.

Results:
Median last solid food intake was 12 hours (4–48 hours), while median last liquid intake was 11 hours (4–16 hours). Prolonged fasting was common, with 26.7% of children fasting for solids more than 12 hours and 12.1% fasting for liquids over 12 hours. The most consumed solids were breakfast items (33%), and water was the predominant liquid (66.9%). No significant relationship was found between fasting durations and subjective feelings of hunger/thirst. Vital signs showed significant decreases in systolic and diastolic blood pressure and mean arterial pressure over the first 20 minutes of surgery (p<0.001). Importantly, a positive correlation was noted between prolonged liquid fasting and perfusion index (PI) at minutes 10 and 15.

• Conclusion:

The findings reveal that actual preoperative fasting durations often exceed recommended guidelines without significant adverse effects on perioperative hemodynamic stability. Nonetheless, the observed correlation between prolonged liquid fasting and PI suggests potential subtle physiological effects. The study highlights the need for improved education and communication regarding fasting guidelines to optimize perioperative care for pediatric patients.