The current state and implications of pre-operative fasting time in children: a systematic review and meta-analysis

Abstract

Previous clinical practice suggests that prolonged fasting could negatively impact their hemodynamic stability and lead to children's dissatisfaction with the perioperative experience. Fasting guidelines for children are frequently updated. This study aims to explore the status of pre-operative fasting time in children and observe the practice of guidelines in clinical practice. A comprehensive search was conducted until 27 March 2024 in English. We used Stata14.0 for meta-analysis. We used the JBI cross-sectional study quality assessment tool to evaluate the quality. We applied a random effects model to conduct a separate meta-regression analysis on the age and the sample size. Our meta-analysis included 10 studies, with 1694 and 3527 children respectively included in solid and liquid fasting time. The effect magnitude of pre-operative solids fasting time was 12.694 [95% confidence interval (CI), 11.962-13.426, I²: 94.2%, p = 0.001], and the liquid fasting time was 8.379 (95% CI, 6.031-10.727, I²: 99.7%, p < 0.001), both exceedingly greater than twice the recommended time in the guidelines. The duration of preoperative fasting in children differs significantly from international guidelines, and evidence-based improvements are needed in clinical practice. Future research should focus on existing obstacles and how to address them.

Keywords: Children; Guideline; Liquid; Preoperative fasting time; Solid.