Department of Anesthesiology, The Second Xiangya Hospital, Central South University, Changsha, China.
Anesthesia Medical Research Centre, Central South University, Changsha, China.
Paediatr Anaesth. 2020 May;30(5):599-606. doi: 10.1111/pan.13853. Epub 2020 Mar 25.
A recent consensus statement in Europe has suggested that the fasting time for clear liquid in children can be shortened to 1 hour before a surgery. However, the study to show that 1-hour fasting time for clear fluids is safe in young children is still lacking. This study aimed to investigate the gastric emptying time for carbohydrate-rich drink and regular 5% glucose solution in children aged 3-7 years.
After overnight fasting, individuals were randomly assigned to ingest 5 mL kg of either carbohydrate-rich drink or 5% glucose solution. One week later, the same subjects were asked to ingest the other one. Ultrasonography was performed to examine the gastric contents. Gastric antral cross-sectional area was measured, and the gastric fluid volume was calculated before and after fluid ingestion within 120 minutes. The primary outcome was the gastric emptying time for both the clear fluids calculated using the antral cross-sectional area and logarithms of gastric fluid volume. The degrees of thirst and hunger of two drinks were evaluated using a visual analogue scale as the secondary outcomes.
Data from 16 individuals were analyzed. In the glucose solution group, the antral cross-sectional area and logarithms of gastric fluid volume returned to baseline at 30 minutes after ingestion. However, in the carbohydrate-rich drink group, the median [interquartile range; range] antral cross-sectional area (3.69 [2.64-5.15; 1.83-8.93] cm vs 2.41 [2.10-2.96; 1.81-4.37] cm , P < .001) and mean (95% confidence interval) logarithms of gastric fluid volume (2.54 [2.30-2.79] mL vs 2.12 [1.94-2.30] mL, P = .048) were still higher than at 60 minutes and returned to the baseline values at 90 minutes after ingestion, respectively. The degree of thirst was lower in the glucose solution group than that in the carbohydrate-rich drink group.
Gastric emptying of carbohydrate-rich drink is slower than that of 5% glucose solution but the residual gastric fluid volume is low one hour after ingestion of 5 mL kg of either fluid.
最近在欧洲的一份共识声明建议，儿童在手术前可将清饮禁食时间缩短至 1 小时。然而，仍缺乏研究表明 1 小时的清饮禁食时间对幼儿是安全的。本研究旨在调查富含碳水化合物的饮料和常规 5%葡萄糖溶液在 3-7 岁儿童中的胃排空时间。
过夜禁食后，个体被随机分配饮用 5mL/kg 的富含碳水化合物的饮料或 5%葡萄糖溶液。一周后，同一组被要求饮用另一种。超声检查检查胃内容物。测量胃窦横截面积，并在 120 分钟内测量液体摄入前后的胃液量。主要结局是使用胃窦横截面积和胃液量对数计算两种液体的胃排空时间。两种饮料的口渴和饥饿程度通过视觉模拟量表评估作为次要结局。
对 16 名个体的数据进行了分析。在葡萄糖溶液组，摄入后 30 分钟胃窦横截面积和胃液量对数恢复到基线。然而，在富含碳水化合物的饮料组，中位数[四分位间距；范围]胃窦横截面积（3.69[2.64-5.15；1.83-8.93]cm 比 2.41[2.10-2.96；1.81-4.37]cm，P<.001）和平均（95%置信区间）胃液量对数（2.54[2.30-2.79]mL 比 2.12[1.94-2.30]mL，P=.048）仍高于 60 分钟，分别在摄入后 90 分钟恢复到基线值。葡萄糖溶液组的口渴程度低于富含碳水化合物的饮料组。
富含碳水化合物的饮料胃排空速度比 5%葡萄糖溶液慢，但两种液体 5mL/kg 摄入后 1 小时胃内残留液量较低。
