Adherence to pre-operative fasting guidelines and associated factors among pediatric surgical patients in selected public referral hospitals, Addis Ababa, Ethiopia: Cross sectional study

Background: Fasting before anesthesia is mandatory in children to reduce the complications of regurgitation, vomiting, and aspiration during anesthesia and surgery. Prolonged fasting times have several negative implications in children, because high fluid turnover quickly leads to dehydration, hypotension, metabolic disturbances, and hypoglycemia, resulting in poor anesthetic outcomes. Aims: This study aimed to assess adherence to preoperative fasting guidelines and associated factors among pediatric patients undergoing elective surgery in Addis Ababa public hospitals in Ethiopia in 2020. Methods: A cross-sectional survey was conducted in Addis Ababa, which selected public hospitals in Ethiopia, in 2020. A total of 279 pediatric patients aged < 17 years scheduled for elective surgery were included in the study. Data analysis was performed using SPSS V.21, and the values of the variables and factors were checked for associations using logistic regression. Statistical significance was determined at P-value of < 0.05. The results are presented in text, tables, charts, and graphs. Results: A total of 279 pediatric patients responded to the analysis, with a 98.6% response rate. The majority of the participants (n = 251, 89.96%) did not follow the guidelines for preoperative fasting. The mean fasting time for clear liquids was 10 +/- 4.03 (2-18 h) for breast milk 7.18 +/- 2.26 (3.5-12 h), and for solid foods 13.5 +/- 2.76 (8-19 h). The reasons for which the preoperative fasting delay was due to incorrect order were 35.1%, prior case procedures took longer times 34.1%, and changing sequence of schedule was 20.8%. Conclusion: Most children had prolonged fasting. The staff's instructions and schedules were challenged to follow international fasting guidelines.