Metabolic and inflammatory benefits of reducing preoperative fasting time in pediatric surgery

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Objective: To investigate the metabolic/inflammatory impact of reducing the preoperative fasting time in preschool children. Methods: Forty children were randomly assigned to a fasting group (absolute fasting after 00:00) and a carbohydrate (CHO) group (allowed to ingest, two hours before surgery, a carbohydrate-rich beverage). Blood samples were collected right before and after surgery to quantify the levels of albumin, interleukin-6, glucose, insulin, C-reactive protein and to calculate insulin resistance by the HOMA-IR index. Results: Preoperative fasting time in the CHO group were shorter than in the fasting group (2.49h vs. 11.24h, p <0.001). Pre-and post-surgical CRP levels were significantly lower in the CHO group (p = 0.05 and p = 0.02, respectively). The preoperative CRP/albumin ratios in the CHO group were lower than in the fasting group (p = 0.03). Four patients (21%) in the fasting group but none in the CHO group were hyperglycemic before surgery (p = 0.04). The two groups had similar levels of albumin, interleukin-6, insulin and HOMA index. There were no adverse events. Conclusion: Reducing the preoperative fasting time with carbohydrate-rich beverages improves the perioperative metabolic and inflammatory responses of preschool children undergoing inguinal hernia surgery.




Carvalho, C. A. L. de B., de Carvalho, A. A., Preza, A. D. oliveira G., Nogueira, P. L. B., Mendes, K. B. V., Dock-Nascimento, D. B., & Aguilar-Nascimento, J. E. (2020). Metabolic and inflammatory benefits of reducing preoperative fasting time in pediatric surgery. Revista Do Colegio Brasileiro de Cirurgioes, 47(1), 1–10.

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