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Most youngsters—together with practically 80% of infants—go with out clear liquids earlier than surgical procedure for no less than twice so long as pointers suggest, in keeping with an evaluation of knowledge on greater than 70,000 kids introduced on the ANESTHESIOLOGY 2025 annual assembly.
Wholesome infants and youngsters could safely drink clear liquids, together with water, fruit juices with out pulp and carbohydrate-containing drinks, till two hours earlier than receiving anesthesia, in keeping with pointers from the American Society of Anesthesiologists (ASA).
The rules suggest that kids not drink something inside two hours earlier than the process to scale back the danger of liquid coming into the lungs, which may trigger choking or pneumonia. Nevertheless, fasting longer will be dangerous as a result of it could trigger dehydration, in addition to unhealthy modifications in blood sugar and different chemical compounds within the physique.
“Prolonged fasting from clear liquids of four hours or longer can be uncomfortable and increase thirst, anxiety, pain, nausea and vomiting,” mentioned Alexander Nagrebetsky, M.D., M.Sc., senior creator of the examine and an anesthesiologist and intensivist at Massachusetts Normal Hospital, Boston and assistant professor at Harvard Medical College, Cambridge, Massachusetts.
“It can be harmful too. Children and infants are especially vulnerable to dehydration and calorie loss, which may heighten stress and slow recovery from surgery.”
Researchers reviewed information from 71,835 kids, aged 17 or youthful (3,771 of whom had been infants youthful than 1 12 months previous), who had elective surgical procedure at certainly one of 12 U.S. hospitals between 2016 and 2024. Within the examine, extended fasting was outlined as fasting from clear liquids for 4 hours (or longer) earlier than surgical procedure, which is 2 instances longer (or extra) than pointers suggest.
Total, the proportion of kids who fasted from clear liquids for no less than two instances longer than really useful earlier than surgical procedure decreased from 84.3% in 2016 to 70.2% in 2024, however elevated in infants, from 75.9% in 2016 to 79.6% in 2024.
The median size of time all kids fasted from clear liquids decreased total from 10.9 hours in 2016 to eight.7 hours in 2024. Nevertheless, there was no vital enchancment in infants, who fasted a median of 6.7 hours in 2016 and 6.3 hours in 2024. In 2024 alone, the median period of clear liquid fasting was 3 times longer than the advice in infants and 4 instances longer in all kids.
Whereas the examine did not tackle why mother and father and well being care professionals withheld clear liquids from kids for longer than really useful, there are probably a number of causes: mother and father and physicians could also be following outdated practices of extended fasting (e.g., nothing to drink after midnight); lack of understanding of ASA fasting pointers that be aware “efforts should be made to allow clear liquids in healthy children as close to two hours before the procedure as possible;” and a lack of knowledge that extended fasting can enhance issues and negatively impression restoration.
Perioperative workforce members ought to encourage sufferers to drink water and liquids with sugar for as much as two hours earlier than the process when applicable, mentioned Dr. Nagrebetsky. Mother and father ought to advocate for his or her kids and ask their anesthesiologist about present suggestions for clear liquids earlier than the process, he mentioned.
“The study confirmed our hypothesis that non-adherence to ASA fasting guidelines is common in the U.S.,” mentioned Ethan Lowder, B.A., lead examine creator and a scholar at Harvard Medical College. “Drinking sugar-containing clear liquids such as juices or those with electrolytes provides water and calories that children’s bodies need for normal functioning, including dealing with the stress of surgery and recovery.”
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Kids abstain from clear liquids for much longer earlier than surgical procedure than pointers suggest, giant examine exhibits (2025, October 12)
retrieved 12 October 2025
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