• Megan A Brockel, McCabe C Kenny, Carter J Sevick, and Vijaya M Vemulakonda.
• Department of Anesthesiology, Section of Pediatric Anesthesiology, Children's Hospital Colorado, 13123 East 16th Avenue, B090, Aurora, CO, 80045, USA. megan.brockel@childrenscolorado.org.
• Pediatr. Surg. Int. 2020 Sep 1; 36 (9): 1111-1116.

PurposeTo assess the impact of modifications in preoperative instructions on parental understanding of preoperative fasting guidelines.MethodsA prospective postoperative parental survey was conducted to assess parental understanding of preoperative fasting requirements in patients undergoing surgery before and after institution of instructions that included visual aids. Data regarding demographics, procedure type, and time to surgery from preoperative visit were also captured. Survey data were compared between pre- and post-intervention groups using Chi-squared tests for categorical variables and Wilcoxon rank sum test for continuous variables.Results173 parents in the pre-intervention group and 162 parents in the post-intervention group were included in the analysis. Parent identification of aspiration risk as the reason for fasting almost doubled after intervention (72.2% vs. 38.2%). There was some evidence of demographic differences between groups; however, in an adjusted model, there was strong evidence (p < 0.001) that parents in the post-intervention group were more likely to identify aspiration as the reason for preoperative fasting (OR 4.73; 95% CI 2.93-7.63).ConclusionsAddition of visual aids in preoperative instructions was associated with improvement in parents' understanding of the rationale behind preoperative fasting instructions. Further studies are needed to determine whether improved understanding is associated with improved adherence.

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