Preoperative fasting in children: A comment on the new guideline from the European Society of Anaesthesiology and Intensive Care Medicine (ESAIC)

The new guideline from the European Society of Anesthesiology and Intensive Care Medicine (ESAIC) has brought forth new recommendations regarding perioperative fasting in children, which represent a step towards enhancing pediatric anesthesia, with a patient-oriented approach. Children should be actively encouraged to drink clear liquids up to the limit of the recommended time, and the intervals for milk of any kind and solid food should be kept as short as possible. This is a new quality and is moving away from the purely prohibitive character of the previous recommendations on the perioperative fasting requirement. In addition to the pure complication considerations (regurgitation, aspiration), factors such as the improvement of the perioperative situation, but also psychological influences on the patient play a much greater role. The now recommended "6-4-3-1" rule has already been implemented in Germany as part of national recommendations. What remains is the question of what distinguishes the young adult from the older child, considering the physiology of gastric emptying. ESAIC is currently working on a reform of the existing fasting regulations for adults.