Preanaesthetic evaluation of fasting blood sugar level in pediatric patients.

Thesis Report.

ABSTRACT: This is a prospective observational study on 'pre-anesthetic evaluation of fasting blood sugar level in pediatric patients' conducted in Kanti Children's hospital in 14 days to 14 years of age with ASA grades I and II. The objective of study was to see the effect of different fasting hours, different age groups and type of last feed on blood glucose concentration. Patients were randomly selected in both day case surgeries and inpatient surgeries with most of them fasted as traditional rule and some were given clear fluid (glucose water) 2-4 hours before induction of anesthesia. Capillary blood sugar estimation was done with glucometer and anesthesia was continued according to standard practice and any complications in peri-operative period were noted upto 24 hours. As in other studies, it is found that there was no significant difference in fasting blood sugar level in different age group i.e. 14 days to 14 years of age, different weight group and with type of last feed given. But there was inverse relation with fasting hours, longer the fasting hours, lower the blood sugar concentration. Incidence of hypoglycemia was 5.6 % according to definition 'fasting blood sugar less than 40 mg/dl' as all children were more than 3 days old. All hypoglycemic children were more than one year old except one and with more than 6 hours of fasting. Most of the infants and neonates were not hypoglycemic even after hours of fasting, but the sample size was small to make relevant conclusion. Shorter fasting hours (2-4 hours) had no immediate effects in intra-operative period and post anesthesia care unit but incidence of postoperative vomiting was same as in longer fasted groups.

Eng.