Comparison of fasting gastric volume using ultrasound in diabetic and non-diabetic patients in elective surgery: An observational study

Heena Garg, Subrata Podder, Indu Bala, Ajay Gulati, Heena Garg, Subrata Podder, Indu Bala, Ajay Gulati

Abstract

Background and aims: Gastroparesis despite standard fasting in diabetic patients may increase the aspiration risk. This study aimed to compare fasting gastric volume (GV) of diabetic with non-diabetic patients scheduled for elective surgery using USG.

Methods: This prospective observational study included 53 diabetic and 50 non-diabetic patients aged >18 years, American Society of Anesthesiologists' physical status I-III having similar fasting intervals. Before induction, using standard gastric scanning protocol, qualitative and quantitative assessments of gastric antrum in supine and right lateral decubitus (RLD) positions were performed with a curved array probe. USG grade, cross-sectional area (CSA) of the antrum and GV were calculated. The gastric antrum was classified as Grade 0, 1 or 2, signifying empty antrum, fluid in RLD position only and antral fluid in both supine and RLD positions, respectively.

Results: In supine position, CC and AP diameters were 1.96 ± 0.41 cm and 0.9 ± 0.57 cm in control group and 2.28 ± 0.50 cm and 1.39 ± 0.44 cm in diabetic group, respectively. In RLD, CC was 2.28 ± 0.57 cm and AP was 1.24 ± 0.42 cm in control group as compared to CC 2.54 ± 0.56 cm and AP 1.82 ± 0.56 cm in diabetic group. The CSA of 2.57 ± 1.19 cm2 and 3.73 ± 1.61 cm2 in diabetic were significantly higher (P = 0.001) than 1.41 ± 0.55 cm2 and 2.30 ± 1.18 cm2 of control, in supine and RLD positions, respectively. GV was 4.20 ± 22.26 ml in control group and 9.15 ± 25.70 ml in diabetic group.

Conclusion: Diabetic patients have higher gastric antral cross-sectional area and gastric volumes as observed by gastric ultrasound than the non-diabetic patients.

Keywords: Diabetes mellitus; fasting; gastric volume; gastroparesis; ultrasound.

Conflict of interest statement

There are no conflicts of interest.

Copyright: © 2020 Indian Journal of Anaesthesia.

Figures

Figure 1
Figure 1
Craniocaudal (CC) and anteroposterior (AP) diameters for calculating the cross-sectional area (CSA). liver (L) on the right, inferior vena cava (IVC) below
Figure 2
Figure 2
Comparison of diameter, cross-sectional area (CSA) and gastric volume (GV) in control and diabetic patients

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