Gastric emptying times of obese and non-obese school-aged children after preoperative clear fluid intake: A prospective observational study.

Abstract

Liberal fasting regimens, which support clear fluid intake up to 1h before surgery in children scheduled for elective surgery, are taking their place in guidelines. However, because of the lack of publications that investigate the gastric emptying time in preoperative obese children, the practice of 1-hour clear fluid fasting in obese children remained at the level of recommendation with weak evidence. The primary aim was to investigate whether there is a difference in gastric emptying times between obese and non- obese children after preoperative intake of 3mL/kg clear liquid containing 5% dextrose by using ultrasound. A total of 70 children were included in the study in two groups, 35 obese and 35 non-obese, aged 6-14 years, who were scheduled for elective surgery. The baseline antral cross-sectional area measurements of the children in the groups were made using ultrasound. 3 mL/kg 5% dextrose was consumed. Ultrasound was repeated immediately after fluid intake and every 5min until the antral cross-sectional area was at the baseline level. The difference in median (IQR [range]) gastric emptying times (minutes) of non-obese {35 [30.0-45.0 (20-60)]} and obese children {35 [30.0-40.0 (25-60)]} were not statistically significant (median of differences 0.0, 95% CI -5.0 to 5.0; p=.563). The antral cross-sectional area and weight-adjusted gastric volumes returned to the baseline level within 60 min after the intake of clear liquid with 3mL/kg 5% dextrose in all children in both groups. Obese and non-obese children have similar gastric emptying times, and these groups can be offered clear fluids containing 3mL/kg 5% dextrose 1h before the surgery.