<clinical_study>
  <!-- This xml conforms to an XML Schema at:
    https://clinicaltrials.gov/ct2/html/images/info/public.xsd -->
  <required_header>
    <download_date>ClinicalTrials.gov processed this data on September 20, 2023</download_date>
    <link_text>Link to the current ClinicalTrials.gov record.</link_text>
    <url>https://clinicaltrials.gov/ct2/show/NCT03273517</url>
  </required_header>
  <id_info>
    <org_study_id>58080016.8.0000.5472</org_study_id>
    <nct_id>NCT03273517</nct_id>
  </id_info>
  <brief_title>Caregivers and Resident Doctors' Perceptions of Preoperative Fasting in Children</brief_title>
  <official_title>Caregivers and Resident Doctors' Perceptions of Preoperative Fasting in Children</official_title>
  <sponsors>
    <lead_sponsor>
      <agency>Faculdade de Ciências Médicas da Santa Casa de São Paulo</agency>
      <agency_class>Other</agency_class>
    </lead_sponsor>
  </sponsors>
  <source>Faculdade de Ciências Médicas da Santa Casa de São Paulo</source>
  <oversight_info>
    <has_dmc>Yes</has_dmc>
    <is_fda_regulated_drug>No</is_fda_regulated_drug>
    <is_fda_regulated_device>No</is_fda_regulated_device>
  </oversight_info>
  <brief_summary>
    <textblock>
      Historically, adults and children who undergo elective surgery remain fasting in the&#xD;
      preoperative period, for the purposes of avoiding bronchial aspiration of the gastric&#xD;
      contents during general anesthesia. The determination of preoperative fasting has taken on&#xD;
      importance only in 1946, when Mendelson established a relationship between pulmonary&#xD;
      aspiration during labor and general anesthesia. Stemming from other studies, such concept has&#xD;
      been expanded to elective surgery and 25 ml were set as the maximum threshold of the gastric&#xD;
      content to thus reduce the hazards of aspiration pneumonia.&#xD;
&#xD;
      The fasting time prescribed is still the subject of several investigations. For decades it&#xD;
      has been established that patients should not feed on solids or ingest liquids over a period&#xD;
      of 8 to 12 hours prior to surgery.&#xD;
&#xD;
      The guidelines are well set in connection with the rules of fasting, with aims at making the&#xD;
      instructions constant throughout different services worldwide. In 2011, the American and the&#xD;
      European guidelines became more permissive and determined as safe the 2 hours for liquids&#xD;
      devoid of residue, 4 hours for breast milk, 6 hours for infant formula and non-human milk, 6&#xD;
      hours for light meals, and 8 hours for full meals. In accordance with the American guideline,&#xD;
      liquids devoid of residue are: water, fruit juice with no pulp, carbohydrate-based beverages,&#xD;
      tea with no residue, and black coffee, but those examples are not extensive. Gelatin is solid&#xD;
      prior to intake, but it is found in a liquid state inside the stomach and, therefore, it is&#xD;
      regarded as a liquid devoid of residue. Yet, in spite of the non-human milk's being a liquid&#xD;
      material, it features a gastric emptying time which is similar to that of the non-fat solids.&#xD;
      A light meal is characterized by toast and liquids devoid of residue, whilst a full meal&#xD;
      includes food that is fried or which contains a high level of fat.&#xD;
&#xD;
      Currently, many directives (American Society of Anaesthesiologists - ASA; Norwegian National&#xD;
      Consensus Guideline - NNCG; Association of Anaesthetists of Great Britain and Ireland -&#xD;
      AAGBI) recommend liquids devoid of residue until two hours prior to the anesthetic induction&#xD;
      for elective surgery in healthy children. The particular benefit of the oral intake of fluids&#xD;
      includes a lower incidence of deleterious effects, such as thirst, irritation, crying,&#xD;
      hypoglycemia, and dehydration. The preservation of the intravascular volume improves the&#xD;
      hemodynamic conditions during the induction of inhalation anesthesia and facilitates the&#xD;
      vascular access.&#xD;
&#xD;
      Even though the old instruction of &quot;nothing by mouth after midnight&quot; is in a process of being&#xD;
      replaced by shorter periods of fasting, both surgeons and anesthesiologists still deem the&#xD;
      traditional fast indispensable and have trouble with implementing the new norms, either by&#xD;
      uncertainty before the possibility of the catastrophic consequences of pulmonary aspiration,&#xD;
      or by lack of update on the subject. That matter generates mistakes in the rendering of&#xD;
      information by the health professionals. Combined with the unawareness of the guardians in&#xD;
      respect of the risk of bronchial aspiration and the anxiety in relation to the fasting, there&#xD;
      is a result of difficulty in abidance by the proper preoperative fasting.&#xD;
&#xD;
      The minority of the guardians understands the real importance of the preoperative fasting&#xD;
      and, many times, food regarded as &quot;harmless&quot; is offered during the period of fasting.&#xD;
      Likewise, the guardians provide improper information in order to maintain the surgical&#xD;
      procedure, with no regard for the correct observance of the fasting. That way, countless&#xD;
      pediatric elective surgeries are canceled, deriving in psychological, social, and economic&#xD;
      implications. The correction of these flaws will allow for the anesthetic procedure to take&#xD;
      place in a more secure manner, with the proper observance of the fasting period and with the&#xD;
      least possible trauma to the child.&#xD;
    </textblock>
  </brief_summary>
  <detailed_description>
    <textblock>
      Cross-sectional, observational study in which questionnaires will be applied to the guardians&#xD;
      during the immediate post-surgical period in the anesthetic recovery room by residents of the&#xD;
      third year of anesthesiology.&#xD;
&#xD;
      Moreover, the knowledge of the physicians of the surgical specialties of the aforementioned&#xD;
      institution pursuant to preoperative fasting is to be assessed, whilst a questionnaire will&#xD;
      be applied after the meetings of the respective departments.&#xD;
&#xD;
      After explication of the study, the Informed Consent Form will be handed in the&#xD;
      pre-anesthetic consultation, and the questionnaires will be applied in the post-anesthetic&#xD;
      recovery room to the guardians of the children who have undergone imaging examination and&#xD;
      elective surgery. After the anesthetic induction, the patients will be subject to the&#xD;
      measurement of blood glucose by Dextro. The resident doctors will be evaluated by means of&#xD;
      another questionnaire, which is to be applied after the weekly clinical meeting of each&#xD;
      specialty.&#xD;
    </textblock>
  </detailed_description>
  <overall_status>Unknown status</overall_status>
  <last_known_status>Recruiting</last_known_status>
  <start_date type="Actual">August 1, 2016</start_date>
  <completion_date type="Anticipated">November 1, 2017</completion_date>
  <primary_completion_date type="Actual">September 1, 2017</primary_completion_date>
  <study_type>Observational</study_type>
  <has_expanded_access>No</has_expanded_access>
  <study_design_info>
    <observational_model>Cohort</observational_model>
    <time_perspective>Prospective</time_perspective>
  </study_design_info>
  <primary_outcome>
    <measure>Glycemia</measure>
    <time_frame>An average of 1 hour after induction of general anesthesia</time_frame>
    <description>After the anesthetic induction, the patients will be subject to the measurement of blood glucose by Dextro.</description>
  </primary_outcome>
  <primary_outcome>
    <measure>The understanding and the perception of the guardians in relation to the importance of fasting in pediatric patients</measure>
    <time_frame>1 hour after post-anesthetic</time_frame>
    <description>The questionnaires will be applied to the guardians of the children who have undergone imaging examination and elective surgery</description>
  </primary_outcome>
  <secondary_outcome>
    <measure>Knowledge of the resident doctors</measure>
    <time_frame>Through study completion, an average of 1 year</time_frame>
    <description>The knowledge of the physicians of the surgical specialties of the aforementioned institution pursuant to preoperative fasting is to be assessed, whilst a questionnaire will be applied</description>
  </secondary_outcome>
  <enrollment type="Anticipated">120</enrollment>
  <condition>Fasting</condition>
  <intervention>
    <intervention_type>Procedure</intervention_type>
    <intervention_name>Elective surgery</intervention_name>
    <description>Elective surgery in children aged 0-15 years ASA I and II</description>
  </intervention>
  <eligibility>
    <study_pop>
      <textblock>
        -  Children below 15 years of age, subject to ophthalmological, otorhinolaryngological,&#xD;
             orthopedic, and pediatric elective surgery and imaging examinations, with ASA I and II&#xD;
             physical condition, and their guardians, over a period of three months.&#xD;
&#xD;
          -  Resident doctors of the specialties of general and pediatric surgery, ophthalmology,&#xD;
             otorhinolaryngology, anesthesia, general orthopedics, a pediatric orthopedics.&#xD;
      </textblock>
    </study_pop>
    <sampling_method>Non-Probability Sample</sampling_method>
    <criteria>
      <textblock>
        Inclusion Criteria:&#xD;
&#xD;
          -  Literate parents or guardians;&#xD;
&#xD;
          -  Children with indication for general anesthesia;&#xD;
&#xD;
          -  Children between 0 and 15 years of age;&#xD;
&#xD;
          -  Children with ASA I and II physical condition.&#xD;
&#xD;
          -  Resident doctors of the specialties of general and pediatric surgery, ophthalmology,&#xD;
             otorhinolaryngology, anesthesia, general orthopedics, a pediatric orthopedics.&#xD;
&#xD;
        Exclusion Criteria:&#xD;
&#xD;
          -  Children subject to anesthetic induction by means of the rapid sequence technique.&#xD;
&#xD;
          -  Children with alterations in the gastric emptying (diabetes, obesity, neonatal hypoxic&#xD;
             encephalopathy, usage of gastrostomy and of nasogastric and nasoenteric probes).&#xD;
      </textblock>
    </criteria>
    <gender>All</gender>
    <minimum_age>N/A</minimum_age>
    <maximum_age>15 Years</maximum_age>
    <healthy_volunteers>Accepts Healthy Volunteers</healthy_volunteers>
  </eligibility>
  <overall_contact>
    <last_name>Ligia Mathias, Doctor</last_name>
    <phone>+ 55 11 99386-0059</phone>
    <email>rtimao@uol.com.br</email>
  </overall_contact>
  <overall_contact_backup>
    <last_name>Débora de Oliveira Cumino</last_name>
    <email>dcumino@gmail.com</email>
  </overall_contact_backup>
  <location>
    <facility>
      <name>Santa Casa of São Paulo Medical School</name>
      <address>
        <city>São Paulo</city>
        <state>SP</state>
        <country>Brazil</country>
      </address>
    </facility>
    <status>Recruiting</status>
    <contact>
      <last_name>Débora de Oliveira Cumino</last_name>
      <email>dcumino@gmail.com</email>
    </contact>
    <investigator>
      <last_name>Carolina Lima Moura</last_name>
      <role>Sub-Investigator</role>
    </investigator>
    <investigator>
      <last_name>Fernanda Bourroul Villela Pedras</last_name>
      <role>Sub-Investigator</role>
    </investigator>
    <investigator>
      <last_name>Maíra Fernandes Gonçalves</last_name>
      <role>Sub-Investigator</role>
    </investigator>
  </location>
  <location_countries>
    <country>Brazil</country>
  </location_countries>
  <results_reference>
    <citation>Buller Y, Sims C. Prolonged fasting of children before anaesthesia is common in private practice. Anaesth Intensive Care. 2016 Jan;44(1):107-10. doi: 10.1177/0310057X1604400116.</citation>
    <PMID>26673596</PMID>
  </results_reference>
  <results_reference>
    <citation>Cantellow S, Lightfoot J, Bould H, Beringer R. Parents' understanding of and compliance with fasting instruction for pediatric day case surgery. Paediatr Anaesth. 2012 Sep;22(9):897-900. doi: 10.1111/j.1460-9592.2012.03903.x. Epub 2012 Jun 25.</citation>
    <PMID>22731386</PMID>
  </results_reference>
  <results_reference>
    <citation>Cook-Sather SD, Litman RS. Modern fasting guidelines in children. Best Pract Res Clin Anaesthesiol. 2006 Sep;20(3):471-81. doi: 10.1016/j.bpa.2006.02.003.</citation>
    <PMID>17080697</PMID>
  </results_reference>
  <results_reference>
    <citation>Flick RP, Schears GJ, Warner MA. Aspiration in pediatric anesthesia: is there a higher incidence compared with adults? Curr Opin Anaesthesiol. 2002 Jun;15(3):323-7. doi: 10.1097/00001503-200206000-00008.</citation>
    <PMID>17019220</PMID>
  </results_reference>
  <results_reference>
    <citation>Green CR, Pandit SK, Schork MA. Preoperative fasting time: is the traditional policy changing? Results of a national survey. Anesth Analg. 1996 Jul;83(1):123-8. doi: 10.1097/00000539-199607000-00022.</citation>
    <PMID>8659722</PMID>
  </results_reference>
  <results_reference>
    <citation>Kushnir J, Djerassi R, Sofer T, Kushnir T. Threat perception, anxiety and noncompliance with preoperative fasting instructions among mothers of children attending elective same day surgery. J Pediatr Surg. 2015 May;50(5):869-74. doi: 10.1016/j.jpedsurg.2014.08.018. Epub 2014 Oct 1.</citation>
    <PMID>25783336</PMID>
  </results_reference>
  <results_reference>
    <citation>MENDELSON CL. The aspiration of stomach contents into the lungs during obstetric anesthesia. Am J Obstet Gynecol. 1946 Aug;52:191-205. doi: 10.1016/s0002-9378(16)39829-5. No abstract available.</citation>
    <PMID>20993766</PMID>
  </results_reference>
  <results_reference>
    <citation>Moro ET. [Prevention of pulmonary gastric contents aspiration.]. Rev Bras Anestesiol. 2004 Apr;54(2):261-75. doi: 10.1590/s0034-70942004000200014. Portuguese.</citation>
    <PMID>19471734</PMID>
  </results_reference>
  <results_reference>
    <citation>Ramirez-Mora J, Moyao-Garcia D, Nava-Ocampo AA. Attitudes of Mexican anesthesiologists to indicate preoperative fasting periods: A cross-sectional survey. BMC Anesthesiol. 2002 May 17;2(1):3. doi: 10.1186/1471-2253-2-3.</citation>
    <PMID>12019024</PMID>
  </results_reference>
  <results_reference>
    <citation>Schreiner MS, Triebwasser A, Keon TP. Ingestion of liquids compared with preoperative fasting in pediatric outpatients. Anesthesiology. 1990 Apr;72(4):593-7. doi: 10.1097/00000542-199004000-00002.</citation>
    <PMID>2321772</PMID>
  </results_reference>
  <results_reference>
    <citation>Smith I, Kranke P, Murat I, Smith A, O'Sullivan G, Soreide E, Spies C, in't Veld B; European Society of Anaesthesiology. Perioperative fasting in adults and children: guidelines from the European Society of Anaesthesiology. Eur J Anaesthesiol. 2011 Aug;28(8):556-69. doi: 10.1097/EJA.0b013e3283495ba1.</citation>
    <PMID>21712716</PMID>
  </results_reference>
  <results_reference>
    <citation>Warner MA. Is pulmonary aspiration still an important problem in anesthesia? Curr Opin Anaesthesiol. 2000 Apr;13(2):215-8. doi: 10.1097/00001503-200004000-00023.</citation>
    <PMID>17016306</PMID>
  </results_reference>
  <results_reference>
    <citation>American Society of Anesthesiologists Committee. Practice guidelines for preoperative fasting and the use of pharmacologic agents to reduce the risk of pulmonary aspiration: application to healthy patients undergoing elective procedures: an updated report by the American Society of Anesthesiologists Committee on Standards and Practice Parameters. Anesthesiology. 2011 Mar;114(3):495-511. doi: 10.1097/ALN.0b013e3181fcbfd9. No abstract available.</citation>
    <PMID>21307770</PMID>
  </results_reference>
  <verification_date>June 2017</verification_date>
  <study_first_submitted>June 29, 2017</study_first_submitted>
  <study_first_submitted_qc>September 2, 2017</study_first_submitted_qc>
  <study_first_posted type="Actual">September 6, 2017</study_first_posted>
  <last_update_submitted>September 2, 2017</last_update_submitted>
  <last_update_submitted_qc>September 2, 2017</last_update_submitted_qc>
  <last_update_posted type="Actual">September 6, 2017</last_update_posted>
  <responsible_party>
    <responsible_party_type>Principal Investigator</responsible_party_type>
    <investigator_affiliation>Faculdade de Ciências Médicas da Santa Casa de São Paulo</investigator_affiliation>
    <investigator_full_name>Lígia Andrade da Silva Telles mathias</investigator_full_name>
    <investigator_title>Doctor</investigator_title>
  </responsible_party>
  <keyword>Glycemia</keyword>
  <keyword>Preoperative fasting</keyword>
  <keyword>Pediatric patients</keyword>
  <keyword>Anesthesia</keyword>
  <keyword>Knowledge of the resident</keyword>
  <patient_data>
    <sharing_ipd>No</sharing_ipd>
  </patient_data>
  <!-- Results have not yet been posted for this study                                          -->
</clinical_study>


download date: ClinicalTrials.gov processed this data on September 20, 2023
link text: Link to the current ClinicalTrials.gov record.
url: https://clinicaltrials.gov/ct2/show/NCT03273517
org study id: 58080016.8.0000.5472
nct id: NCT03273517
lead sponsor: 
has dmc: Yes
is fda regulated drug: No
is fda regulated device: No
Historically, adults and children who undergo elective surgery remain fasting in the
      preoperative period, for the purposes of avoiding bronchial aspiration of the gastric
      contents during general anesthesia. The determination of preoperative fasting has taken on
      importance only in 1946, when Mendelson established a relationship between pulmonary
      aspiration during labor and general anesthesia. Stemming from other studies, such concept has
      been expanded to elective surgery and 25 ml were set as the maximum threshold of the gastric
      content to thus reduce the hazards of aspiration pneumonia.

      The fasting time prescribed is still the subject of several investigations. For decades it
      has been established that patients should not feed on solids or ingest liquids over a period
      of 8 to 12 hours prior to surgery.

      The guidelines are well set in connection with the rules of fasting, with aims at making the
      instructions constant throughout different services worldwide. In 2011, the American and the
      European guidelines became more permissive and determined as safe the 2 hours for liquids
      devoid of residue, 4 hours for breast milk, 6 hours for infant formula and non-human milk, 6
      hours for light meals, and 8 hours for full meals. In accordance with the American guideline,
      liquids devoid of residue are: water, fruit juice with no pulp, carbohydrate-based beverages,
      tea with no residue, and black coffee, but those examples are not extensive. Gelatin is solid
      prior to intake, but it is found in a liquid state inside the stomach and, therefore, it is
      regarded as a liquid devoid of residue. Yet, in spite of the non-human milk's being a liquid
      material, it features a gastric emptying time which is similar to that of the non-fat solids.
      A light meal is characterized by toast and liquids devoid of residue, whilst a full meal
      includes food that is fried or which contains a high level of fat.

      Currently, many directives (American Society of Anaesthesiologists - ASA; Norwegian National
      Consensus Guideline - NNCG; Association of Anaesthetists of Great Britain and Ireland -
      AAGBI) recommend liquids devoid of residue until two hours prior to the anesthetic induction
      for elective surgery in healthy children. The particular benefit of the oral intake of fluids
      includes a lower incidence of deleterious effects, such as thirst, irritation, crying,
      hypoglycemia, and dehydration. The preservation of the intravascular volume improves the
      hemodynamic conditions during the induction of inhalation anesthesia and facilitates the
      vascular access.

      Even though the old instruction of "nothing by mouth after midnight" is in a process of being
      replaced by shorter periods of fasting, both surgeons and anesthesiologists still deem the
      traditional fast indispensable and have trouble with implementing the new norms, either by
      uncertainty before the possibility of the catastrophic consequences of pulmonary aspiration,
      or by lack of update on the subject. That matter generates mistakes in the rendering of
      information by the health professionals. Combined with the unawareness of the guardians in
      respect of the risk of bronchial aspiration and the anxiety in relation to the fasting, there
      is a result of difficulty in abidance by the proper preoperative fasting.

      The minority of the guardians understands the real importance of the preoperative fasting
      and, many times, food regarded as "harmless" is offered during the period of fasting.
      Likewise, the guardians provide improper information in order to maintain the surgical
      procedure, with no regard for the correct observance of the fasting. That way, countless
      pediatric elective surgeries are canceled, deriving in psychological, social, and economic
      implications. The correction of these flaws will allow for the anesthetic procedure to take
      place in a more secure manner, with the proper observance of the fasting period and with the
      least possible trauma to the child.
Cross-sectional, observational study in which questionnaires will be applied to the guardians
      during the immediate post-surgical period in the anesthetic recovery room by residents of the
      third year of anesthesiology.

      Moreover, the knowledge of the physicians of the surgical specialties of the aforementioned
      institution pursuant to preoperative fasting is to be assessed, whilst a questionnaire will
      be applied after the meetings of the respective departments.

      After explication of the study, the Informed Consent Form will be handed in the
      pre-anesthetic consultation, and the questionnaires will be applied in the post-anesthetic
      recovery room to the guardians of the children who have undergone imaging examination and
      elective surgery. After the anesthetic induction, the patients will be subject to the
      measurement of blood glucose by Dextro. The resident doctors will be evaluated by means of
      another questionnaire, which is to be applied after the weekly clinical meeting of each
      specialty.
observational model: Cohort
time perspective: Prospective
measure: Glycemia
time frame: An average of 1 hour after induction of general anesthesia
description: After the anesthetic induction, the patients will be subject to the measurement of blood glucose by Dextro.
measure: The understanding and the perception of the guardians in relation to the importance of fasting in pediatric patients
time frame: 1 hour after post-anesthetic
description: The questionnaires will be applied to the guardians of the children who have undergone imaging examination and elective surgery
measure: Knowledge of the resident doctors
time frame: Through study completion, an average of 1 year
description: The knowledge of the physicians of the surgical specialties of the aforementioned institution pursuant to preoperative fasting is to be assessed, whilst a questionnaire will be applied
intervention type: Procedure
intervention name: Elective surgery
description: Elective surgery in children aged 0-15 years ASA I and II
study pop: 
sampling method: Non-Probability Sample
criteria: 
gender: All
minimum age: N/A
maximum age: 15 Years
healthy volunteers: Accepts Healthy Volunteers
last name: Ligia Mathias, Doctor
phone: + 55 11 99386-0059
email: rtimao@uol.com.br
last name: Débora de Oliveira Cumino
email: dcumino@gmail.com
facility: 
status: Recruiting
contact: 
investigator: 
investigator: 
investigator: 
country: Brazil
citation: Buller Y, Sims C. Prolonged fasting of children before anaesthesia is common in private practice. Anaesth Intensive Care. 2016 Jan;44(1):107-10. doi: 10.1177/0310057X1604400116.
PMID: 26673596
citation: Cantellow S, Lightfoot J, Bould H, Beringer R. Parents' understanding of and compliance with fasting instruction for pediatric day case surgery. Paediatr Anaesth. 2012 Sep;22(9):897-900. doi: 10.1111/j.1460-9592.2012.03903.x. Epub 2012 Jun 25.
PMID: 22731386
citation: Cook-Sather SD, Litman RS. Modern fasting guidelines in children. Best Pract Res Clin Anaesthesiol. 2006 Sep;20(3):471-81. doi: 10.1016/j.bpa.2006.02.003.
PMID: 17080697
citation: Flick RP, Schears GJ, Warner MA. Aspiration in pediatric anesthesia: is there a higher incidence compared with adults? Curr Opin Anaesthesiol. 2002 Jun;15(3):323-7. doi: 10.1097/00001503-200206000-00008.
PMID: 17019220
citation: Green CR, Pandit SK, Schork MA. Preoperative fasting time: is the traditional policy changing? Results of a national survey. Anesth Analg. 1996 Jul;83(1):123-8. doi: 10.1097/00000539-199607000-00022.
PMID: 8659722
citation: Kushnir J, Djerassi R, Sofer T, Kushnir T. Threat perception, anxiety and noncompliance with preoperative fasting instructions among mothers of children attending elective same day surgery. J Pediatr Surg. 2015 May;50(5):869-74. doi: 10.1016/j.jpedsurg.2014.08.018. Epub 2014 Oct 1.
PMID: 25783336
citation: MENDELSON CL. The aspiration of stomach contents into the lungs during obstetric anesthesia. Am J Obstet Gynecol. 1946 Aug;52:191-205. doi: 10.1016/s0002-9378(16)39829-5. No abstract available.
PMID: 20993766
citation: Moro ET. [Prevention of pulmonary gastric contents aspiration.]. Rev Bras Anestesiol. 2004 Apr;54(2):261-75. doi: 10.1590/s0034-70942004000200014. Portuguese.
PMID: 19471734
citation: Ramirez-Mora J, Moyao-Garcia D, Nava-Ocampo AA. Attitudes of Mexican anesthesiologists to indicate preoperative fasting periods: A cross-sectional survey. BMC Anesthesiol. 2002 May 17;2(1):3. doi: 10.1186/1471-2253-2-3.
PMID: 12019024
citation: Schreiner MS, Triebwasser A, Keon TP. Ingestion of liquids compared with preoperative fasting in pediatric outpatients. Anesthesiology. 1990 Apr;72(4):593-7. doi: 10.1097/00000542-199004000-00002.
PMID: 2321772
citation: Smith I, Kranke P, Murat I, Smith A, O'Sullivan G, Soreide E, Spies C, in't Veld B; European Society of Anaesthesiology. Perioperative fasting in adults and children: guidelines from the European Society of Anaesthesiology. Eur J Anaesthesiol. 2011 Aug;28(8):556-69. doi: 10.1097/EJA.0b013e3283495ba1.
PMID: 21712716
citation: Warner MA. Is pulmonary aspiration still an important problem in anesthesia? Curr Opin Anaesthesiol. 2000 Apr;13(2):215-8. doi: 10.1097/00001503-200004000-00023.
PMID: 17016306
citation: American Society of Anesthesiologists Committee. Practice guidelines for preoperative fasting and the use of pharmacologic agents to reduce the risk of pulmonary aspiration: application to healthy patients undergoing elective procedures: an updated report by the American Society of Anesthesiologists Committee on Standards and Practice Parameters. Anesthesiology. 2011 Mar;114(3):495-511. doi: 10.1097/ALN.0b013e3181fcbfd9. No abstract available.
PMID: 21307770
responsible party type: Principal Investigator
investigator affiliation: Faculdade de Ciências Médicas da Santa Casa de São Paulo
investigator full name: Lígia Andrade da Silva Telles mathias
investigator title: Doctor
sharing ipd: No