Relationship of preoperative fasting time with vital signs and type and dose of analgesic in pediatrics

authors:

avatar Fatemeh Moshtaghi , avatar Akram Aarabi , * , avatar Sedighe Shahhosseini

Koomesh: Vol.24, issue 5; 605-613
published online: September 01, 2022
article type: Research Article
received: July 01, 2021
accepted: April 01, 2022

how to cite: Moshtaghi F, Aarabi A, Shahhosseini S. Relationship of preoperative fasting time with vital signs and type and dose of analgesic in pediatrics. koomesh. 2022;24(5):e152771. 

Abstract

Introduction: According to studies, children are often kept fasting in intervals longer than the standard fasting time, which can lead to complications for them. So, there was little and contradictory evidence about fasting time and its complications, this study aimed to investigate the relationship between preoperative fasting time with vital signs and the type and dose of analgesic in pediatrics. Materials and Methods: In this cross-sectional research, 192 children aged between 6-36 months were surveyed in a specialized center for children. Children were examined through a researcher-made form in terms of preoperative fasting time, the type and dose of analgesic, as well as post-operative respiratory rate, pulse rate, and temperature through observation, pulse oximetry, and tympanic thermometer. Results: The mean fasting time was 8.09 hours. Fasting time was higher in children who took Apotel (P=0.03). The fasting time was significantly and directly related to the dose of Apotel and also to the total dose of the three drugs (P<0.001 and P<0.001, respectively). The mean body temperature of children who fasted for more than six hours was significantly lower than other children (P<0.001). Conclusion: The fasting time of children was more than standard times. Using a higher dose of Apotel and the total higher dose of three analgesic drugs suggests the existence of more pain in patients with longer fasting times. Moreover, increased fasting time led to a decrease in the temperature in pediatric patients. Therefore, it is necessary to reduce the fasting time of children to prevent the complications associated with it.

References

  • 1.

    Kafrouni H, Ojaimi RE. Preoperative fasting guidelines in children: should they be revised? Case Rep Anesthesiol 2018; 2018: 8278603.

  • 2.

    Weledji EP, Njong SN, Chichom A, Verla V, Assob JC, Ngowe MN. The effects of preoperative carbohydrate loading on the metabolic response to surgery in a low resource setting. Int J Surg Open 2017; 8: 18e23.##https://doi.org/10.1016/j.ijso.2017.06.002.

  • 3.

    Njoroge G, Kivuti-Bitok L, Kimani S. Preoperative fasting among adult patients for elective surgery in a kenyan referral hospital. Int Sch Res Notices 2017; 2017: 2159606.

  • 4.

    Dolgun E, Yavuz M, Eroglu B, Islamoglu A. Investigation of preoperative fasting times in children. J Perianesth Nurs 2017; 32: 121-124.

  • 5.

    Frykholm P, Schindler E, Sumpelmann R, Walker R, Weiss M. Preoperative fasting in children: review of exiting guidelines and recent developments. Br J Anesthesia 2018; 120: 469-474.

  • 6.

    Williams C, Johnson PA, Guzzetta CE, Guzzetta PC, Cohen IT, Sill AM, et al. Pediatric fasting times before surgical and radiologic procedures: benchmarking institutional practices against national standards. J Pediatr Nurs 2014; 29: 258-267.

  • 7.

    Carvalho CA, Carvalho AA, Nogueira PL, Aguilar-Nascimento JE. Changing paradigms in preoperative fasting: results of a joint effort in pediatric surgery. ABCD Arq Bras Cir Dig 2017; 30: 7-10.

  • 8.

    Tudor-Drobjewski BA, Marhofer P, Kimberger O, Huber W.D, Roth G, Triffterer L. Randomised controlled trial comparing preoperative carbohydrate loading with standard fasting in paediatric anaesthesia. Br J Anaesthesia 2018; 121: 656e661.

  • 9.

    Mesbah A, Thomas M. Preoperative fasting in children. BJA Educ 2017; 17: 346-350.##https://doi.org/10.1093/bjaed/mkx021.

  • 10.

    Togo HY, Lopes EC. Preoperative fasting reduction in burned patients: A systematic review. Burns Open 2020; 4: 176-182.##https://doi.org/10.1016/j.burnso.2020.06.004.

  • 11.

    Arun BG, Korula G. Preoperative fasting in children: An audit and its implications in a tertiary care hospital. J Anaesthesiol Clin Pharmacol 2013; 29: 88.

  • 12.

    Gebremedhn EG, Nagaratnam VB. Audit on preoperative fasting of elective surgical patients in an African Academic Medical Center. World J Surg 2014; 38: 2200-2204.

  • 13.

    El-Sharkawy AM, Daliya P, Lewis-Lloyd Ch, Adiamah A, Malcolm FL, Boyd-Carson H, Lobo DN. Fasting and surgery timing (FaST) audit. Clin Nutr 2020.

  • 14.

    Abebe W.A, Rukewe A, Bekele NA, Stoffel M, Dichabeng MN, Shifa JZ. Preoperative fastig times in elective surgical patients at a referral Hospital in Botswana. Pan Afr Med J 2016; 23: 102.

  • 15.

    Torabi-Khah M, Yousefi H, Monazami Ansari AH, Musarezaie A. Prevalence of postoperative nausea and vomiting and pain in patients undergoing elective orthopaedic surgery in iran. J Perianesth Nurs 2018; 35: 294-297 (Persian).

  • 16.

    Brunet-Wood K, Simons M, Evasiuk A, Mazurak V, Dicken B, Ridley D, Larsen B. Surgical fasting guidelines in children: Are we putting them into practice? J Pediatr Surg 2016; 51: 1298-1302.

  • 17.

    Chauvin C, Schalber-Geyer AS, Lefebvre F, Bopp C, Carrenard G, Marcoux L, et al. Early postoperative oral fluid intake in pediatric day case surgery influences the need for opioids and postoperative vomiting: a controlled randomized trial. Br J Anaesth 2017; 118: 407-414.

  • 18.

    Klemetti S, Kinnunen I, Suominen T, Antila H, Vahlberg T, Grenman R, Leino-Kilpi H. The effect of preoperative fasting on postoperative pain, nausea and vomiting in pediatric ambulatory tonsillectomy. Int J Pediatr Otorhinolaryngol 2009; 73: 263-273.

  • 19.

    Phillips NM. Berry & Kohn's operating room technique. 13th ed. chapter 8; 129. 2017. Elsevier Mosby.##.

  • 20.

    Fox P, Higham H. Preoperative fast heart rate: a harbinger of perioperative adverse cardiac events. Br J Anaesthesia 2016; 117: 271-274.

  • 21.

    Muller L, Brie're M, Bastide S, Roger C, Zoric L, Seni G, et al. Preoperative fasting does not affect haemodynamic status: a prospective, non-inferiority, echocardiography study. Br J Anaesthesia 2014; 112: 835-841.

  • 22.

    Manjunath G, Aravindhakshan R, Varghese Sh. Effect of fasting during Ramadan on thermal stress parameters. East Mediterr Health J 2019; 25: 34-39.

  • 23.

    Kkazemimajd S, Amiri Z, Jahanpoor F, Rostami F. Comparison of the accuracy of various methods of measuring body temperature in three months to five years old children. J Gorgan Uni Med Sci 2017; 18: 81-87 (Persian).

  • 24.

    Abbasi R, Amoozgar H, Ghahramanifar M, Keshavarz K,Vafaei F, Saeedinegad SZ, et al. The comparison of pulse oximetry and cardiac catheterization in managing the treatment of children with congenital heart disease. Armaghane-danesh, Yasuj Univ Med Sci J 2015; 19: 1096-1104 (Persian).

  • 25.

    Singh BN, Dahiya D, Bagaria D, Saini V, Kaman L, Kaje V, et al. Effects of preoperative carbohydrates drinks on immediate postoperative outcome after day care laparoscopic cholecystectomy. Surg Endosc 2015; 29: 3267-3272.

  • 26.

    Avazah, Khosh Fetrat M, Rahimi Bashar F. Effect of progressive muscle relaxation on the vital signs and oxygenation indexes in patients under coronary artery bypass graft surgery: A triple blinded randomized clinical trial. Koomesh 2019; 21: 423-436 (Persian).

  • 27.

    Potter PA, Stockert PA. Fundamentals of nursing. 9th ed. Unit 5. 2017; Elsevier Mosby.

  • 28.

    Baradaranfard F, Ghadami A, Jabalameli M, Aarabi A. Comparing the efficacy of two warming methods on physiological indices of patients undergoing laparoscopic cholecystectomy. Koomesh 2020; 22: 50-59 (Persian).##https://doi.org/10.29252/koomesh.22.1.50.

  • 29.

    Wang Y, Li X, Guo Ch. The association of nil per os (NPO) with necrotizing entrocolitis. Gastroenterol Res Pract 2018; 2018: 2795468.