Gastric emptying of preoperative carbohydrate in elderly assessed using gastric ultrasonography: A randomized controlled study. Issue 37 (17th September 2021)

• Record Type: Journal Article
• Authors: Jeong, Jae Yong; Ahn, Jin Hee; Shim, Jae-Geum; Lee, Sung Hyun; Ryu, Kyoung-Ho; Lee, Sung-Ho; Cho, Eun-Ah
• Other Names: Kim. Young-Kug section editor.
• Is Part Of: Medicine. Volume 100:Issue 37(2021)
• Publication Date: 2021-09-17
• Subjects: carbohydrate -- elderly -- gastric emptying -- gastric ultrasonography; Medicine -- Periodicals; Medicine -- Periodicals; Médecine -- Périodiques; Geneeskunde; Medicine; Periodicals; Periodicals; 610.5
• DOI: 10.1097/MD.0000000000027242
• Languages: English
• ISSNs: 0025-7974

Abstract

Abstract: Background: Preoperative carbohydrate loading enhances postoperative recovery and reduces patient discomfort. However, gastric emptying of liquids can be delayed in elderly populations. Therefore, this study aimed to evaluate the gastric emptying of 400 mL of a carbohydrate drink ingested 2 hours before surgery in elderly patients. Methods: In this prospective, randomized controlled study, patients aged >65 years were allocated to either fast from midnight (nil per os [NPO] group, n = 29) or drink 400 mL of a carbohydrate drink 2 hours before surgery (carbohydrate group, n = 29). The gastric antrum was assessed using ultrasonography in the supine position, followed by the right lateral decubitus (RLD) position. The gastric antrum was graded as grade 0 (fluid not seen in both positions), grade 1 (fluid only seen in the RLD position), and grade 2 (fluid seen in both positions). The gastric antral cross-sectional area (CSA) and aspirated residual gastric volume were measured. Results: In 58 patients, the incidence of grade 2 stomach was 13.8% in NPO group and 17.2% in carbohydrate group ( P = .790). The gastric antral CSA in the supine position was larger in carbohydrate group than in NPO group (4.42 [3.72–5.18] cm 2 vs 5.31 [4.35–6.92] cm 2, P = .018). The gastric antral CSA in the RLD position was not different in NPO and carbohydrate groups ( P = .120). There was no difference in gastric volume (2 [0–7.5] vs 3 [0–13.4], P = .331) in NPO group versus carbohydrate group. Conclusion: The incidence of grade 2 stomach was not different between NPO group and carbohydrate group in elderly patients.