Preoperative oral given clear liquid in childrengastric emptying evaluated by ultrasound, preoperative anxiety andeffect on peroperative blood sugarcomparison

Aim: Preoperative fasting periods in pediatric patients aim to prevent complications that may occur due to inappropriate fasting periods. The emptying period of clear liquids is faster than that of particulate liquids. The emptying period of clear liquids is affected by volume, calories, and individual digestive differences. European guidelines report that the fasting period can be reduced to 1 hour. With this study, we aimed to show the negative effects of prolonged fasting in children who were allowed to drink fluids up to 2 hours before preoperatively and in children who followed the standard fasting period, and to show that we can easily intervene in cases where gastric ultrasound is predicted to be aspirated as part of our daily practice. Materials and Methods: Our study was approved by the Ethics Committee of Erzincan Binali Yıldırım University. 66 pediatric patients between the ages of 3-12 who were planned to undergo elective surgery and met the inclusion criteria were included in the study. Group CL (n=33) was allowed to drink clear liquids up to 2 hours before surgery. Group FA (n=33) was asked to comply with the standard fasting period. Gastric ultrasonography and volume measurement were performed on the patients when they first arrived at the operating room. Aspiration risk was determined according to Perla's score. Anxiety score, blood sugar, family satisfaction, systolic blood pressure, diastolic blood pressure, mean arterial pressure, pulse, actual fasting periods, preoperative and postoperative nausea and vomiting symptoms were recorded. Results: Aspiration did not occur in children who were given fluids at 5 ml/kg and in children who were asked to comply with the standard fasting period. The surgical orders of pediatric patients with Perla's scores above 2 were changed, and no relationship was found between the Perla's scores of these patients and the fasting period. There was no difference between the two groups in terms of preoperative and postoperative nausea and vomiting symptoms. Nausea and vomiting symptoms were found to be related to the type of surgery. The response of the fluid group to surgical stress was better than the group that complied with the standard fasting period in terms of blood sugar and mean arterial pressure values. The m-YPAS score of the fluid group was found to be significantly lower (p<0.01) and family satisfaction was significantly higher (p<0.001). Conclusions: In our study, we found that fluid intake of 5 ml/kg up to 2 hours before the preoperative period was safe and the aspiration risk score was not related to the duration of fluid intake, perioperative hemodynamic and blood sugar values were better and the response to surgical stress decreased, family satisfaction increased during the short fasting period and the anxiety score of the pediatric patient decreased, and the risk of aspiration could be eliminated with gastric ultrasonography, which can be performed in a short time and easily.