Should children undergo surgery without a long period of fasting after feeding?

Blood glucose levels in a lot of patients fed normal liquid food (NLF) and a high calorie diet (HCD) were high. There was no significant difference in the blood prealbumin levels. There was a significant increase in the blood cortisol levels in some patients. The stress of surgery may be tolerated by children by feeding up to 2 h before elective surgery.

A research article to be published on October 21, 2009 in the World Journal of Gastroenterology addresses this question. A group from Turkey investigated whether children should undergo surgery without a long period of fasting after feeding. The routine use of perioperative oral dietary supplements in patients about to undergo gastrointestinal surgery confers no clinical or functional benefit. This routine is now being questioned, because fasting causes discomfort and unnecessary problems with routine oral medication.

In this study, blood glucose levels increased and stomach residue liquids were at a tolerable level in all patients fed NLF and an HCD. The results indicated that children can tolerate the stress of surgery when they are fed until 2 h before surgery, because there was no difference regarding stomach residue and metabolic changes among patients that underwent surgery after fasting for short and long periods.

These results demonstrate that the stress of surgery may be tolerated by children by feeding up to 2 h before elective surgery. The authors believe that there is no need for more than 2 h of fasting before inguinoscrotal region surgery.

Reference: Yurtcu M, Gunel E, Sahin TK, Sivrikaya A. Effects of fasting and preoperative feeding in children. World J Gastroenterol 2009; 15(39): 4919-4922

http://www.wjgnet.com/1007-9327/15/4919.asp

Correspondence to: Dr. Muslim Yurtcu, Department of Pediatric Surgery, Meram Medical School of Selcuk University, Konya 42080, Turkey. muslimyurtcu@hotmail.com

Telephone: +90-332-2236546 Fax: +90-332-2237236

World Journal of Gastroenterology (WJG), a leading international journal in gastroenterology and hepatology, has established a reputation for publishing first class research on esophageal cancer, gastric cancer, liver cancer, viral hepatitis, colorectal cancer, and H. pylori infection and provides a forum for both clinicians and scientists. WJG has been indexed and abstracted in Current Contents/Clinical Medicine, Science Citation Index Expanded (also known as SciSearch) and Journal Citation Reports/Science Edition, Index Medicus, MEDLINE and PubMed, Chemical Abstracts, EMBASE/Excerpta Medica, Abstracts Journals, Nature Clinical Practice Gastroenterology and Hepatology, CAB Abstracts and Global Health. ISI JCR 2008 IF: 2.081. WJG is a weekly journal published by WJG Press. The publication dates are the 7th, 14th, 21st, and 28th day of every month. WJG is supported by The National Natural Science Foundation of China, No. 30224801 and No. 30424812, and was founded with the name of China National Journal of New Gastroenterology on October 1, 1995, and renamed WJG on January 25, 1998.