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Abstract：
The current guidelines for preoperative fasting recommend intervals of 6, 4, and 2 h (6-4-2) of fasting for solids, breast milk, and clear fluids, respectively. The objective is to minimize the risk of pulmonary aspiration of gastric contents, but also to prevent unnecessarily long fasting intervals. Pulmonary aspiration is rare and associated with nearly no mortality in paediatric anaesthesia. The incidence may have decreased during the last decades, judging from several audits published recently. However, several reports of very long fasting intervals have also been published, in spite of the implementation of the 6-4-2 fasting regimens. In this review, we examine the physiological basis for various fasting recommendations, the temporal relationship between fluid intake and residual gastric content, and the pathophysiological effects of preoperative fasting, and review recent publications of various attempts to reduce the incidence of prolonged fasting in children. The pros and cons of the current guidelines will be addressed, and possible strategies for a future revision will be suggested.
摘要：
目前的术前禁食指南建议禁食6、4和2小时（6-4-2）母乳,和清澈的液体，分别。目的是尽量减少胃内容物肺部吸入的风险，但也要防止不必要的长禁食间隔。在儿科麻醉中，肺吸入很少见，几乎没有死亡。在过去的几十年中，发病率可能有所下降，从最近公布的几次审计来看。然而,也发表了一些关于很长的禁食间隔的报告，尽管实施了6-4-2禁食方案。在这次审查中,我们检查了各种禁食建议的生理基础，液体摄入量和残余胃内容物之间的时间关系，术前禁食的病理生理影响，并回顾最近发表的各种尝试，以减少儿童长时间禁食的发生率。现行准则的利弊将予以处理,并将提出未来修订的可能策略。
