Anesthesia Clinical Trial
Official title:
Evaluation of the Impact of Semi-sitting Position Versus Supine Position on Gastric Emptying in Children Using Gastric Ultrasound: a Randomized Controlled Trial
The aim of this work is to evaluate the effect of semi sitting versus supine positions on
gastric emptying of fluids in children using gastric ultrasound.
The investigators hypothesize that gastric emptying in children might be faster if the
patient is in semi-sitting position. This hypothesis could impact the current guidelines for
peri-operative fasting. Moreover, if this proved effective, could be used for enhancement of
gastric emptying before emergency operations in non-fasting patient.
Dealing with preoperative fasting requires a meticulous balance ensuring patient safety and
lessening patient's discomfort. Although fasting is a basic requirement for avoiding
pulmonary aspiration, it is sometimes associated with patient discomfort and hypoglycemia.
According to the current guidelines for preoperative fasting of children, fasting is required
for 2-hours, 4-hours, and 6-hours period after ingestion of water, breast milk, and infant
formula respectively. Limited data is available for the effect of patient positioning on
gastric emptying. A previous study had reported that gastric emptying of non-nutrient liquids
was faster in the sitting position compared with the left lateral position . Another study
showed similar findings after nutritive liquid and solid meals; whilst, a third study had
reported that gravity has a little effect on gastric emptying.
In pediatric population the effect of posture on the duration of gastric emptying is not well
investigated.
Gastric ultrasound is a valid, accurate, reproducible, non-invasive, bedside test for
evaluation of the gastric volume. gastric ultrasound has been validated in adults as well as
children for estimating the volume of gastric contents and evaluating gastric emptying.
The aim of this work is to evaluate the effect of semi sitting versus supine positions on
gastric emptying of fluids in children using gastric ultrasound.
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