Paediatric anaesthesia
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Paediatric anaesthesia · Jul 2023
Preoperative Clear Fluid Fasting and Endoscopy-measured Gastric Fluid Volume in Children.
In light of new recommendations to shorten clear fluid fasting time before anesthesia, our study aimed at exploring residual fluid volume in the stomach after different fasting times. We intended to perform direct endoscopic aspiration of stomach contents under vision, as part of routine gastroscopy assessment. Hereby we would be able to quantify true residual gastric fluid volume and acidity in children and measure their correlation with fasting times. ⋯ In children undergoing gastroscopy, we could not demonstrate any association between clear fluid fasting time and the child's residual gastric fluid volume per kg body weight. Since we did not see a clinically relevant association between clear fluids fasting time and gastric residual volume, this study may support the recommendation to shorten clear fluids fasting time.
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Paediatric anaesthesia · Jul 2023
Observational StudyGastric Emptying Times of Obese and Non-obese School-aged Children After Preoperative Clear Fluid Intake: A Prospective Observational Study.
Liberal fasting regimens, which support clear fluid intake up to 1 h 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. ⋯ Obese and non-obese children have similar gastric emptying times, and these groups can be offered clear fluids containing 3 mL/kg 5% dextrose 1 h before the surgery.
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Paediatric anaesthesia · Jul 2023
ReviewError Traps in the Perioperative Care of Children with Chronic Pain.
Pediatric patients with a history of chronic pain frequently have complex health needs that are challenging to meet in the perioperative period. Error traps are consequences or errors that are known to occur due to either gaps in knowledge or cognitive errors. ⋯ Cognitive errors may play a role in these error traps. Recognizing and avoiding them may improve and optimize pain care and outcome.