Clear Liquid Fasting Guidelines for Pediatric Patients: A Survey of the Society for Pediatric Anesthesia.

Document Type

Article

Publication Date

9-2025

Identifier

DOI: 10.1111/pan.15140

Abstract

INTRODUCTION: Recently, several international anesthesia societies have updated their guidelines by shortening the NPO clear liquid time from 2 to 1 h in children. When the American Society of Anesthesiologists (ASA) released their interim update to the preoperative fasting guidelines, they maintained the 2-h clear liquid fasting recommendation, while advising the use of clinical judgment for cases involving PO intake within 2 h. Given international support for decreased NPO times, we aimed to evaluate the current practice and opinions of the Society for Pediatric Anesthesia (SPA) members regarding clear liquid NPO times.

METHODS: A 17-question survey was developed by members of Children's Mercy Kansas City Department of Anesthesiology and submitted to the SPA Research Committee for review. After approval, a survey link and QR code were distributed to all SPA members.

RESULTS: A total of 430 surveys (9.85%) were completed. Seventy-three percent indicated that their department follows a 2-h NPO policy for clear liquids, while 24% reported a 1-h policy. Overall, 71% of respondents felt that 1-h is the ideal NPO time for clear liquids. Of the respondents whose department follows a 2-h policy, 86% believe their NPO policy would be shortened if ASA guidelines were updated to 1-h. Forty-nine percent of respondents reported that NPO instructions to patients are congruent with departmental policies, while 33% reported that NPO instructions differ from departmental NPO policies.

DISCUSSION: The results demonstrate that although only a small number of respondents practice a 1-h policy, most respondents believe that a 1-h policy is ideal. This discrepancy is potentially due to adherence to ASA practice guidelines/recommendations, as 86% of respondents who have an NPO policy of 2 or more hours indicated that their departments would switch to 1-h if the ASA were to revise their guideline.

Journal Title

Paediatric anaesthesia

Volume

35

Issue

9

First Page

761

Last Page

767

MeSH Keywords

Humans; Fasting; Child; Societies, Medical; Pediatrics; Surveys and Questionnaires; Anesthesia; Practice Guidelines as Topic; Anesthesiology; Pediatric Anesthesia

PubMed ID

40476655

Keywords

fasting; pediatric anesthesia; pediatrics; practice guideline; preoperative care; survey

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