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Year : 2020  |  Volume : 64  |  Issue : 1  |  Page : 85  

Operative fasting guidelines and postoperative feeding – Current concepts


Department of Anesthesia, Christian Medical College, Vellore, Tamil Nadu, India

Date of Submission19-Nov-2019
Date of Acceptance02-Dec-2019
Date of Web Publication7-Jan-2020

Correspondence Address:
Dr. Ekta Rai
Department of Anesthesia, Christian Medical College, Vellore - 632 004, Tamil Nadu
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ija.IJA_849_19

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How to cite this article:
Toms AS, Rai E. Operative fasting guidelines and postoperative feeding – Current concepts. Indian J Anaesth 2020;64:85

How to cite this URL:
Toms AS, Rai E. Operative fasting guidelines and postoperative feeding – Current concepts. Indian J Anaesth [serial online] 2020 [cited 2020 Sep 24];64:85. Available from: http://www.ijaweb.org/text.asp?2020/64/1/85/275231



Sir,

We appreciate the interest in the article with acceptance towards a liberal approach for clear fluids.[1] We aimed to provide the current updates on established data on fasting guidelines both preoperative and postoperative through this article. Mention of special situations is to highlight the possibility of deviations from normalcy. We need to remember that all obese children don't regurgitate and aspirate at induction or extubation phase.[2] Morbidly obese children are at greater risk, due to increased intraabdominal pressure and more chances of hiatus hernia.[3] Aspiration depends on multiple factors such as diabetes mellitus, raised intracranial pressure, hiatus hernia, gastrointestinal obstruction, recurrent regurgitation, dyspeptic symptoms, intermittent positive pressure ventilation insufflating gas into the stomach,[4] lighter plane of anaesthesia evoking the airway reflexes and gastrointestinal motor responses leading to distension of the stomach and thus aspiration. Currently, no guidelines exist to quantitatively define the duration of fasting for these special situations. To do justice to the topic, a separate review article highlighting the effect of obesity on anaesthetic management in children is needed.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
   References Top

1.
Zhu B, Gui Y. Supplement information of fasting time for obese children. Indian J Anaesth 2020;64:84.  Back to cited text no. 1
  [Full text]  
2.
Beck-Scimmer B, Bonvini JM. Bronchoaspiration: Incidence, consequences and management. Eur J Anaesthesiol 2011;28:78-84.  Back to cited text no. 2
    
3.
Sidaras G, Hunter JM. Is it safe to artificially ventilate a paralysed patient through the laryngeal mask? The jury is still out. Br J Anaesth 2001;86:749-53.  Back to cited text no. 3
    
4.
Asai T. Who is at risk of pulmonary aspiration? Br J Anaesth 2004;93:497-500.  Back to cited text no. 4
    




 

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