Hemodynamics and arterial oxygen saturation during preoperative emptying of the stomach

Abstract

We studied the hemodynamic response to preoperative emptying of the stomach by means of a gastric tube in 20 non-fasting non-premedicated patients aged 39 (24-54) (median and quartiles) presenting for emergency surgery. Systolic and diastolic blood pressure and heart rate increased by 24.4% (P less than 0.01), 29.9% (P less than 0.01) and 36% (P less than 0.01), respectively. Arterial oxygen saturation decreased by 2.1% (P less than 0.01). The rate pressure product increased by 68% (P less than 0.01), exceeding 20,000 (mmHg.min-1) [2667 kPa.min-1] in nine patients. The cardiovascular response is of the same magnitude as reported after tracheal intubation without use of analgesics and is likely to cause cardiac ischemia and other adverse effects in patients suffering from coronary artery disease.

Erythromycin for Gastric Emptying in Patients Undergoing General Anesthesia for Emergency Surgery

“…Stomach drainage with a gastric tube 17 does not guarantee complete emptying. Also, preoperative insertion of a gastric tube in a nonsedated patient is not without hazards 18 and is only recommended in patients with bowel obstruction. An alternative would be to administer a prokinetic drug before induction of anesthesia.…”

Compressão da cartilagem cricóide: aspectos atuais

“…Vale lembrar que a sondagem gástrica não é um procedimento isento de riscos. Kristensen e col. 42 estudaram a resposta hemodinâmica de 20 indivíduos, não-anestesiados e considerados de estômago cheio que foram submetidos à drenagem pré-operatória do conteúdo gástrico. Segundo os autores, as alterações cardiovasculares foram semelhantes às observadas durante a intubação traqueal de pacientes acordados.…”

“…One should not forget that the nasogastric tube is not devoid of risks. Kristensen et al 42 evaluated the hemodynamic response of 20 non-anesthetized individuals, considered to be on a full stomach, undergoing preoperative drainage of gastric contents. According to the authors, cardiovascular changes were similar to those observed during tracheal intubation in awake patients.…”

Prevention of aspiration pneumonitis in the obstetric patient

“…Although stomach tubes do reduce gastric volume, they cannot guarantee an empty stomach. The procedure is extremely inconvenient and may produce detrimental effects both in the baby and mother (12,13). Hence, most authors do not recommend routinely preoperative mechanical e m p tying of the stomach.…”