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Abstract

The new guideline from the European Society of Anesthesiology and Intensive Care Medicine (ESAIC) has brought forth
new recommendations regarding perioperative fasting in children, which represent a step towards enhancing pediatric
anesthesia, with a patient-oriented approach. Children should be actively encouraged to drink clear liquids up to the
limit of the recommended time, and the intervals for milk of any kind and solid food should be kept as short as possible.
This is a new quality and is moving away from the purely prohibitive character of the previous recommendations on
the perioperative fasting requirement. In addition to the pure complication considerations (regurgitation, aspiration),
factors such as the improvement of the perioperative situation, but also psychological influences on the patient play a
much greater role. The now recommended “6-4-3-1” rule has already been implemented in Germany as part of national
recommendations. What remains is the question of what distinguishes the young adult from the older child, considering
the physiology of gastric emptying. ESAIC is currently working on a reform of the existing fasting regulations for adults.

Keywords: guideline, recomandations, perioperative fasting, children

Literatura 10. Chiloiro M, Caroli M, Guerra V, Lodadea Piepoli A, Riezzo G. Gastric
emptying in normal weight and obese children--an ultrasound study.
Int J Obes Relat Metab Disord. 1999 Dec;23(12):1303-6.
1. Kocher T. Chirurgische Operationslehre; 1907. 11. Romeo C, Bonanno N, Baldari S, Centorrino A, Scalfari G, Antonuccio P,
2. Bruns P. Handbuch der praktischen Chirurgie: Hansebooks; 1873. et al. Gastric motility disorders in patients operated on for esophageal
atresia and tracheoesophageal fistula: long-term evaluation. J Pediatr
3. Frykholm P, Schindler E, Sümpelmann R, Walker R, Weiss M. Surg. 2000 May;35(5):740-4.
Preoperative fasting in children: review of existing guidelines and
recent developments. Br J Anaesth. 2018 Mar;120(3):469-74. 12. Franken J, Mauritz FA, Stellato RK, Van der Zee DC, Van Herwaarden-
Lindeboom MYA. The Effect of Gastrostomy Placement on Gastric
4. Frykholm P, Disma N, Andersson H, Beck C, Bouvet L, Cercueil E, et al. Function in Children: a Prospective Cohort Study. J Gastrointest Surg.
Pre-operative fasting in children: A guideline from the European Society 2017 Jul;21(7):1105-11.
of Anaesthesiology and Intensive Care. Eur J Anaesthesiol. 2022 Jan
1;39(1):4-25. 13. Yin X, Zeng X, Wang T, Dong B, Wu M, Jia A, et al. Early versus delayed
postoperative oral hydration in children following general anesthesia: a
5. Becke K, Giest J, Strauss J. Handlungsempfehlungen zur präoperativen prospective randomized trial. BMC Anesthesiol. 2020 Jul 18;20(1):174.
Diagnostik, Impfabstand und Nüchternheit im Kindesalter. Anästh
Intensivmed 2007; 48:4. 14. Radke OC, Biedler A, Kolodzie K, Cakmakkaya OS, Silomon M, Apfel CC.
The effect of postoperative fasting on vomiting in children and their
6. Thomas M, Morrison C, Newton R, Schindler E. Consensus statement assessment of pain. Paediatr Anaesth. 2009 May;19(5):494-9.
on clear fluids fasting for elective pediatric general anesthesia. Paediatr
Anaesth. 2018 May;28(5):411-4. 15. Chauvin C, Schalber-Geyer AS, Lefebvre F, Bopp C, Carrenard G,
Marcoux L, et al. Early postoperative oral fluid intake in paediatric
7. Bonner JJ, Vajjah P, Abduljalil K, Jamei M, Rostami-Hodjegan A, Tucker day case surgery influences the need for opioids and postoperative
GT, et al. Does age affect gastric emptying time? A model-based meta- vomiting: a controlled randomized trial†. Br J Anaesth. 2017 Mar
analysis of data from premature neonates through to adults. Biopharm 1;118(3):407-14.
Drug Dispos. 2015 May;36(4):245-57.
8. Moake MM, Presley BC, Hill JG, Wolf BJ, Kane ID, Busch CE, et al. Point-
of-Care Ultrasound to Assess Gastric Content in Pediatric Emergency Konflikt interesa: Nema
Department Procedural Sedation Patients. Pediatr Emerg Care. 2022
Jan 1;38(1):e178-e186. Primljeno: 01. 06. 2023.
9. Bisinotto FM, Pansani PL, Silveira LA, Naves AA, Peixoto AC, Lima HM, Prihvaćeno: 28. 06. 2023.
et al. Qualitative and quantitative ultrasound assessment of gastric Onlajn: 01. 09. 2023.
content. Rev Assoc Med Bras (1992). 2017 Feb;63(2):134-41.

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