One surefire way to start a lively conversation among anesthesiologists is to bring up the ideal timeline children should fast before surgery.
This clinical controversy was the focus of a point-counterpoint discussion at ANESTHESIOLOGY® 2024. Joelle Karlik, MD, Pediatric Anesthesia and Pain Medicine, Children's Healthcare of Atlanta-Arthur M. Blank Hospital, Atlanta, Georgia, makes the case that it's realistic and safe to shorten the fasting time to one hour for many procedures. This article will be followed by a counterpoint from Jerrold Lerman, MD, on reasons to maintain the two-hour window to withhold clear liquids before elective procedures requiring anesthesia.
The 2023 ASA Practice Guidelines for Preoperative Fasting state that the current recommendations are for pediatric patients to strive for clear liquid intake as close to two hours before procedures as possible (Anesthesiology 2023;138:132-51). However, some professionals believe these guidelines are inconsistent with clinical practice, especially in European...
