Castillo-Zamora Carlos, Castillo-Peralta Luz A, Nava-Ocampo Alejandro A
Department of Anesthesia and Respiratory Therapy, Hospital Infantil de México Federico Gómez, Mexico DF, Mexico.
Paediatr Anaesth. 2005 Aug;15(8):638-42. doi: 10.1111/j.1460-9592.2005.01517.x.
We aimed to evaluate the efficacy of clear liquids orally administered at 06:00-06:30 am on the morning of surgery to reduce prolonged preoperative fasting periods.
After obtaining informed parental consent, 100 children undergoing scheduled orthopedic surgical procedures, ASA I-II, were randomly allocated to two groups. In group 1, children underwent the typical overnight preoperative period and patients in group 2 received a commercial brand of apple juice (glucose 28 g in 250 ml) at 06:00-06:30 am on the day of surgery. Patients <3 years old received 15 ml.kg(-1) and older children 10 ml.kg(-1) to a maximum volume of 250 ml. All patients underwent overnight fasting for milk and solids.
Fasting time was 4.8 +/- 2.1 h (ranging from 3 to 11 h) in the group receiving apple juice at 06:00-06:30 am and 13.2 +/- 3.3 h (ranging from 5 to 19 h) in the overnight-fasting group (P < 0.05; 95% CI: -9.6 to -7.4 h). More patients were irritable (odds ratio, OR 4.5; 95% CI: 1.9-10.8) and dehydrated (OR 21.6; 95% CI: 5.9-79.0) in the overnight-fasting group. Glucose levels <2.7 mmol.l(-1) (50 mg.dl(-1)) were not reported in any case.
A 15 ml.kg(-1) of apple juice for patients of <3 years of age or 10 ml.kg(-1) for older children, at 06:00-06:30 am of the surgical morning is a simple procedure to prevent dehydration and to produce positive behavior in low-risk, pediatric surgical patients.
我们旨在评估在手术当天上午06:00 - 06:30口服清液以缩短术前长时间禁食期的效果。
在获得家长知情同意后，100例接受择期骨科手术、ASA I - II级的儿童被随机分为两组。第1组儿童经历典型的术前过夜禁食期，第2组患者在手术当天上午06:00 - 06:30接受一种市售品牌的苹果汁（250毫升含葡萄糖28克）。3岁以下患者按15毫升/千克，大龄儿童按10毫升/千克给予，最大量为250毫升。所有患者均对牛奶和固体食物进行过夜禁食。
在上午06:00 - 06:30接受苹果汁的组中，禁食时间为4.8±2.1小时（范围3至11小时），过夜禁食组为13.2±3.3小时（范围5至19小时）（P < 0.05；95%可信区间：-9.6至-7.4小时）。过夜禁食组中更多患者出现烦躁（优势比，OR 4.5；95%可信区间：1.9 - 10.8）和脱水（OR 21.6；95%可信区间：5.9 - 79.0）。未报告任何病例血糖水平<2.7毫摩尔/升（50毫克/分升）。
对于3岁以下患者给予15毫升/千克、大龄儿童给予10毫升/千克的苹果汁，于手术日上午06:00 - 06:30口服，是一种简单的方法，可预防低风险儿科手术患者脱水并产生积极的行为表现。
