A path to permanently short fasting times in paediatric anaesthesia – a quality safety study

Abstract

Background

In 2018, we shortened the fasting time in our clinic for clear fluid to 1 h. Since 2021 ‘drinking until call to the operating theatre’ applies. This quality assurance study investigates whether this regulation has further shortened the fasting times and which factors influence its implementation.

Methods

In this prospective observational study, a two-part anonymous questionnaire from the attending anaesthetist and the parents was completed.

Results

A total of 204 children were included in the study. The fasting time for clear fluid (median [IQR] (min-max)) was 2 [1–4.6] (0.33–22) hours and was shorter than 3 [2–7.8] (0.5–17) hours in the pre-transition period. More than 50% of the children had access to clear fluid directly at the bedside or freely available on the ward. The children’s drinking behaviour showed that 54% of the children drank on their own and only 4% of the children complained of thirst. When comparing the wards there were differences with regard to the fasting time for clear fluid. There were no differences in the fasting times depending on the operating theatre position. The length of time between the informed consent consultation and anaesthesia or language barriers had a negative influence on adherence to the fasting rules.

Conclusions

Two years after the introduction of the ‘sip til sendʼ rule there was a significant reduction in fasting times. Fasting times did not differ between operating theatre position.

Zusammenfassung

Hintergrund

2018 wurde die NZ in unserer Klinik für klare Flüssigkeit auf 1 h reduziert. Seit 2021 gilt die Regel „Trinken bis zum OP-Abruf“. Diese Qualitätssicherungsstudie untersucht, ob diese Regelung die Nüchternzeiten weiter verkürzt hat und welche Faktoren ihre Umsetzung beeinflussen.

Methoden

In dieser prospektiven Beobachtungsstudie wurde ein zweiteiliger anonymer Fragebogen vom narkoseführenden Anästhesisten und den Eltern ausgefüllt.

Ergebnisse

Insgesamt wurden 204 Kinder in die Studie eingeschlossen. Die Nüchternzeit für klare Flüssigkeit (median [IQR] (min-max)) betrug 2 [1–4.6] (0.33–22) Stunden und war kürzer als im Zeitraum vor der Umstellung mit 3 [2–7.8] (0.5–17) Stunden. Mehr als 50% der Kinder hatten Zugriff auf klare Flüssigkeit direkt am Bett oder freiverfügbar auf der Station. Beim Trinkverhalten der Kinder zeigte sich, dass 54% der Kinder von allein getrunken hatten und nur 4% der Kinder über Durst geklagt hatten. Im Vergleich der Stationen gab es Unterschiede in Bezug auf die Nüchternzeit für klare Flüssigkeit. Die Nüchternzeiten in Bezug auf die OP-Position unterschieden sich nicht. Die Länge des Zeitraums zwischen der Anästhesieaufklärung und dem OP-Termin oder auch Sprachbarrieren beeinflusste die Nüchternzeit negativ.

Schlussfolgerungen

Zwei Jahre nach Einführung der Regel „Trinken bis zum OP-Abruf“ zeigte sich eine signifikante Verkürzung der Nüchternzeiten. Diese unterschieden sich nicht zwischen den OP-Positionen.

Keywords

perioperative fasting - paediatric anaesthesia - sip til send - patient satisfaction - perioperative fasting guidelines

Schlüsselwörter

Perioperative Nüchternzeiten - Kinderanästhesie - Trinken bis Abruf - Patientenzufriedenheit - Nüchternleitlinie

Publication History

Article published online:
01 September 2025

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