Evidence-based practice for preoperative fasting and drinking restrictions in pediatric patients undergoing day surgery with general anesthesia

ZHENG Ya-qi; LYU Yun-xia; ZHANG Mei-xue; YANG Li-fen; XU Xin-ke; LIN Wei

doi:10.13820/j.cnki.gdyx.20250629

Abstract：Objective To implement best evidence regarding preoperative fasting and drinking management for pediatric patients undergoing day surgery with general anesthesia,and to evaluate the effectiveness of its clinical applica-tion.Methods Following an evidence-translation framework,the best evidence for fasting and drinking management was identified through literature retrieval,critical appraisal,and synthesis.A baseline audit was conducted among 212 children undergoing day surgery under general anesthesia from September 1 to 15,2024,to assess barriers and facilitators and to develop an implementation plan.Two rounds of quality audits were then performed among 187 and 218 children,respectively,from October 7 to November 2,2024.Process and outcome indicators were collected before and after practice implementation.Comparisons were made regarding healthcare staff knowledge scores,compliance with audit criteria,pre-operative fasting and drinking duration,pre-and postoperative thirst and hunger scores,incidence of crying,postopera-tive fever and vomiting,length of stay,and preoperative anxiety levels of children and parents.Results After implemen-tation,staff knowledge scores increased from 45-75(61.4±9.9)to 80-100(94.14±6.0).Compliance with audit criteria 3,4,7,12,13,14,15,and 16 increased from 0-51.24％to 86.87％-100％.Median preoperative fasting duration decreased from 14.1(12.2,15.8)hours to 10.9(8.9,11.9)hours,and drinking restriction decreased from 5.7(4.0,12.0)hours to 2.6(2.6,3.4)hours.Levels of pre-/postoperative thirst,hunger,crying incidence,and preoperative anxiety in both children and parents improved significantly(P＜0.001).Conclusion Conclusion Evidence-based practice for preoperative fasting and drinking restrictions in pediatric day-surgery patients under general anesthesia effectively enhances staff compliance with audit criteria,improves knowledge levels,shortens fasting and drinking times,and alleviates discomfort such as thirst,hunger,and crying associated with preoperative restrictions.