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Fasting (according to ASA, ESA or institutional guidelines) is an important strategy to minimize the risk of regurgitation, vomiting and pulmonary aspiration during general anaesthesia; the effect of fasting time for clear fluid on gastric pH in children is goal of this study and can be investigated in children undergoing elective procedures in general anaesthesia and intubation without inconvenience or additional invasive procedure and hence without additional risk
Hypotheses: Gastric pH is higher in children that drink clear fluids until premedication before anaesthesia induction than in those that drink until 2 hours before anaesthesia induction
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| clear fluids until premedication | Experimental | allowed to drink until premedication, aprox 30 minutes before anaesthesia induction. Fasting for solids and non-clear fluids is six hours. |
|
| 2 hours fluid fasting | Active Comparator | allowed to drink until 2 hour before scheduled anaesthesia induction clear fluid Ingestion. Fasting for solids and non-clear fluids is six hours. |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| clear fluid ingestion | Procedure | drinking of clear fluid in preoperative period |
|
| Measure | Description | Time Frame |
|---|---|---|
| gastric pH | gastric pH is measured from gastric contents which is sampled in a syringe via an orogastric tube immediately during anaesthesia after tracheal intubation induction; suctioning of the stomach after intubation is a procedure routinely performed in every intubation child in our institution | within 10 min after tracheal intubation |
| Measure | Description | Time Frame |
|---|---|---|
| gastric aspirate volume | gastric aspirate volume is the amount of gastric contents which is sampled in a syringe via an orogastric tube immediately during anaesthesia after tracheal intubation induction; suctioning of the stomach after intubation is a procedure routinely performed in every intubation child in our institution | within 10 min after tracheal intubation |
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Inclusion Criteria:
age > 1 / < 16 years ASA class l or ll elective surgery requiring general anaesthesia using tracheal intubation
Exclusion Criteria:
disease or dysfunction of gastrointestinal tract chronic diseases or conditions not compatible with ASA class l or ll
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| Name | Affiliation | Role |
|---|---|---|
| Achim J Schmitz, MD | University Children's Hospital, Zurich | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| University Childrens Hospital | Zurich | Canton of Zurich | 8032 | Switzerland |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 30115263 | Derived | Schmidt AR, Buehler KP, Both C, Wiener R, Klaghofer R, Hersberger M, Weiss M, Schmitz A. Liberal fluid fasting: impact on gastric pH and residual volume in healthy children undergoing general anaesthesia for elective surgery. Br J Anaesth. 2018 Sep;121(3):647-655. doi: 10.1016/j.bja.2018.02.065. Epub 2018 May 3. |
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| subjective feeling of hunger/thirst | subjective feeling of hunger/thirst given as "yes" or "no" answer | baseline |
| Postoperative Nausea and Vomiting (PONV) in recovery unit | recovery period, on the average within 90 minutes after end of anaesthesia |
| Behaviour during recovery period | Rating Scale1-5 by blinded nurse (5: severely agitated/emergence delir with subsequent drug therapy, 4: agitated/emergence delir; 3: slightly agitated; 2: complaining pain but cooperative; 1: cooperative) | recovery period, on the average within 90 minutes after end of anaesthesia |
| Behaviour during anaesthesia induction | Rating scale1-5 by (blinded) anaesthetist: 1: cooperating - 2: anxious but cooperating - 3: hostile - 4: crying - 5: agitated/fighting | on the average within 20 minutes after arrival of patient in operating theatre |
| Nurse's Impression of patient's satisfactory | subjective feeling of the Nurse regarding patient's satisfactory given as rating scale from 1 to 4 | baseline |
| blood Ketone measurement | measurement of blood Ketone with a portable poc Ketone measurement device | intraoperative |