Induction, Maintenance, and Emergence from Anesthesia

Lerman, Jerrold; Sampathi, Venkata; Watt, Stacey

doi:10.1002/9781444345186.ch15

Cited by 3 publications

(1 citation statement)

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“…[34] In addition, medical staff did not provide adequate information to patients about preoperative fasting, leading to patients having insu cient understanding about fasting program. [35] Prolonged fasting and drinking may cause a lot of harms, including increasing preoperative insulin resistance,[36-38] enhancing preoperative stress response [39], increasing the incidence of intraoperative hypotension, [40,41] and postoperative nausea and vomiting. [42][43][44] Currently, aspiration risk is mainly assessed by fasting duration, but preoperative fasting duration cannot be used as an indicator for gastric volume.…”

Section: Discussionmentioning

confidence: 99%

Oral carbohydrate 2 hours vs long fasting in risk of reflux and aspiration: a randomized controlled trial conducted on volunteers

Zhang,

Huang,

Feng

et al. 2024

Preprint

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Background: There is controversy over whether carbohydrate drinks should be allowed before surgery due to concerns about aspiration. Methods: Volunteers were randomly assigned to either an experimental group (E) or control group (C). Group E drank less than 400ml of carbohydrate after 6 hours of fasting, while group C continued to fast without any beverage. They received ultrasound evaluation every hour. The primary outcome was the incidence of risk stomach. Results: The total incidences of risk stomach in group E and C were 100% vs 13%, 70% vs 10%, 13.3% vs 6.6%, 10% vs 6.6% at T0, T1, T2, T3 respectively. There were no significant differences between the two groups at T2 and T3. The gastric volume of group E and C were 36.08 ± 16.90 vs 1.01 ± 16.89, 25.67 ± 20.67 vs 0.54 ± 18.10, 6.89 ± 18.32 vs -1.70 ± 15.32, 2.74 ± 16.48 vs -0.70 ± 17.57 at T0, T1, T2, T3 respectively. The VAS of hunger and thirst in the two groups were 0.60 ± 0.62 vs 1.00 ± 0.70, respectively. Conclusion: Oral carbohydrate more than 2 hours before surgery did not increase the incidence of risk stomach and reduced preoperative hunger and thirst. Trial registration: This was also registered prior to patient enrollment at Chinese Clinical Trial Registry. (http://www.chictr.org.cn; Registration date: 7/2/2021; Registration number: ChiCTR2100043166; Principal investigator: Gang Zhang).

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