Ferrari L R, Rooney F M, Rockoff M A
Department of Anesthesia, Children's Hospital, Boston, Massachusetts 02115, USA.
Anesthesiology. 1999 Apr;90(4):978-80. doi: 10.1097/00000542-199904000-00008.
The purpose of this study was to determine current practice patterns for preoperative fasting at major pediatric hospitals.
Fasting guidelines for children at each of the hospitals listed in the second edition of the Directory of Pediatric Anesthesiology Fellowship Programs were solicited and analyzed.
Fifty-one institutions were surveyed, and 44 responded. In 50%, clear fluids were permitted up to 2 h prior to anesthesia for all children. Breast milk was restricted to 4 h for children younger than 6 months in 61% of hospitals. Institutions were equally divided (39% each) between a 4-h and a 6-h fast for formula in infants younger than 6 months; for infants older than 6 months, 50% of hospitals restricted formula feeding to 6 h. There was no consensus for solid feeding in children younger than 3 yr, but 50% of hospitals agree that solids should be restricted after midnight in children older than 3 yr.
There is no uniform fasting practice for children before elective surgery in the United States and Canada. However, there is agreement among most institutions that ingestion of clear fluids 2-3 h prior to general anesthesia is acceptable. Most also accept a 4-h restriction for breast milk and a 6-h restriction for nonhuman formula. There is great diversity among institutions regarding fasting for solids in children, with many restricting intake after midnight. There is little agreement about whether infant formula should be treated in the same way as solid food or how to categorize breast milk.
本研究的目的是确定主要儿科医院术前禁食的当前实践模式。
征集并分析了《儿科麻醉学住院医师培训项目目录》第二版中列出的各医院儿童禁食指南。
共调查了51家机构，44家作出回应。50%的机构允许所有儿童在麻醉前2小时饮用清液。61%的医院将6个月以下儿童的母乳禁食时间限制为4小时。对于6个月以下婴儿，各机构对于配方奶禁食4小时和6小时的比例相同（均为39%）；对于6个月以上婴儿，50%的医院将配方奶喂养限制在6小时。对于3岁以下儿童的固体食物禁食没有达成共识，但50%的医院同意3岁以上儿童午夜后应限制固体食物摄入。
在美国和加拿大，择期手术前儿童的禁食做法并不统一。然而，大多数机构一致认为，全身麻醉前2 - 3小时饮用清液是可以接受的。大多数机构也接受母乳禁食4小时和非母乳配方奶禁食6小时的限制。各机构在儿童固体食物禁食方面存在很大差异，许多机构限制午夜后的摄入量。对于婴儿配方奶是否应与固体食物同等对待或如何对母乳进行分类，几乎没有达成共识。
