Comparative evaluation of gastric pH and volume in morbidly obese and lean patients undergoing elective surgery and effect of aspiration prophylaxis

Ultrasound assessment of gastric volume in severely obese individuals: a validation study

“…21 Obese patients are considered to be at increased risk of pulmonary aspiration in the perioperative period and of aspiration pneumonitis should aspiration occur. [22][23][24][25] In addition, airway management in these patients is more likely to be difficult and prolonged. 25 Although an in-depth discussion of gastric emptying time (GET) is beyond the scope of this study, it is interesting to note that there is no current consensus on the relationship between body weight or BMI and GET.…”

Effect of routine preoperative fasting on residual gastric volume and acid in patients undergoing myomectomy

“…The findings of this randomized trial showed that drinking of carbohydrate-rich fluid 2 h before elective abdominal myomectomy was not associated with complications during surgery and anesthesia. [12,[16][17][18] The RGV in the patients who had such drinks was not statistically different from those who starved for 6-10 h preoperatively. Various randomized controlled studies and a meta-analyze have consistently documented that oral intake of water and other clear fluids up to 2 h before induction of anesthesia does not increase gastric volume or acidity.…”

“…Prolonged fasting may lead to several adverse effects including an increase in catabolic pathways, metabolic derangement and may aggravate insulin resistance. [16][17][18][19] Insulin resistance ordinarily exerts a positive protection in surgery. [20] However, this resistance can have negative consequences for patient health beyond a critical value.…”

Perioperative fasting and feeding in adults, obstetric, paediatric and bariatric population: Practice Guidelines from the Indian Society of Anaesthesiologists

“…The meta-analysis of 5 RCTs comparing residual gastric volume in obese and non-obese individuals showed that obese individuals have a slightly higher residual gastric volume compared to non-obese individuals with a mean difference of 2.47 and a 95% CI of 0.24 to 4.71(LOE- High). [ 300 301 302 303 304 ] The meta-analysis of 4 RCTs comparing gastric content pH showed that obese individuals had lower pH when compared to non-obese individuals with a mean difference of 2.92 and a 95% CI of -5.57 to - 0.31 (LOE- High). [ 300 302 303 304 ]…”