Gastric Emptying Clinical Trial
Official title:
Gastric Emptying Time of a Rice-based Meal Using Serial Sonographic Assessment
Adequate preoperative fasting is critical in preventing pulmonary aspiration of gastric content. Ultrasonography is considering as a useful test assessing the volume of gastric contents, but the emptying time of a rice-based meal (Asian foods) in healthy populations was not clear. The objective of this study was to investigate the minimum fasting time required for adequate gastric emptying after the ingestion of a rice-based meal.
Aspiration of gastric contents into the lungs in surgical patients is a rare, but serious
adverse event. Because a proper preoperative fasting is mandatory before anesthesia to
prevent this severe complication, patients undergoing elective surgery have traditionally
asked to fast overnight to ensure that their stomachs are empty. However, it is difficult and
uncomfortable for patients not to eat or drink, particularly for those scheduled for surgery
later in the day. Fasting may lead to thirst, hunger, anxiety, and tiredness, along with the
potential for hypoglycemia and dehydration. Moreover, prolonged preoperative starvation
triggers a metabolic response that precipitates gluconeogenesis and increases the organic
response to trauma [7,8] and leads to delayed recovery after surgery. Avoiding inordinate
fasting before surgery markedly reduces postoperative insulin resistance which has beneficial
effects on postoperative glucose and protein metabolism.
Current guidelines by the American Society of Anesthesiologists (ASA) recommend a minimum of
6 hours after a light meal (toast and clear fluid) and 8 hours if the meal includes fried or
fatty foods. In the era of evidence-based medicine, however, these fasting recommendations to
keep a patient in preoperative fasting of 6-8 hours after the intake of solid meal are
derived from survey opinions solicited from 470 active members of the ASA membership despite
insufficient literature.
Recent studies have shown that real-time ultrasonography can provide reliable information
about the nature (clear fluid, solid, or none) and volume of gastric content, being a
non-invasive, inexpensive and safe method. The ultrasonographic measurement of antral
cross-sectional area (CSA) is used for the assessment of gastric emptying in diabetic or
dyspeptic patients and clinical investigations in obstetrical anesthesia. Thus, we designed
this study to evaluate scientifically the gastric emptying time of solid meal using serial
sonographic assessment in healthy volunteers. (Especially, there was no study to evaluate the
gastric emptying time of a rice-based meal.) The objective of this study was to confirm or
confront the minimum fasting time required for adequate gastric emptying for a rice-based
meal (Asian foods), according to the suggestion of current guideline.
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