Ultrasound assessment of residual gastric volume in older adults undergoing staged-bilateral total knee arthroplasty after consuming carbohydrate-containing fluids: a prospective observational study

Shin, Hyung-Jin; Kim, Heeyeon; Han, Sung‐Hee; Hwan, Sang; Na, Hyo‐Seok

doi:10.4097/kja.22378

Cited by 2 publications

(4 citation statements)

References 33 publications

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“…The ASA class was higher in the elderly group (2 [1][2]) than in the young group (1 [1-1], <0.001). Fasting time for solids in the young group was 12 (10)(11)(12)(13)(14)(15) hours and that in the elderly group was 15 (14-19) hours (P < .001). Fasting time for fluids did not differ between the groups (P > .05).…”

Section: Resultsmentioning

confidence: 90%

“…As with gastric ultrasound, age is a major factor for calculation of GV. [ 4 , 10 , 14 ] Alternatively, the relationship between the CSA and residual GV in elderly patients is different from that in younger patients. [ 14 ] Thus, for a given GV, the CSA is greater in older patients than in their younger counterpart, due to difference in the gastric compliance.…”

Section: Introductionmentioning

confidence: 99%

“…While it is known that gastric function is well preserved in the elderly patients, the relationship of aging and gastric emptying is inconclusive. [10,11] While there are some debates, gastric emptying can be delayed in elderly patients due to underlying diseases, polypharmacy, and undiagnosed gastroesophageal reflux. [11][12][13] Therefore, it seems even more important to assess gastric emptying with gastric ultrasound in the elderly patients.…”

Section: Introductionmentioning

confidence: 99%

“…[10,11] While there are some debates, gastric emptying can be delayed in elderly patients due to underlying diseases, polypharmacy, and undiagnosed gastroesophageal reflux. [11][12][13] Therefore, it seems even more important to assess gastric emptying with gastric ultrasound in the elderly patients. As with gastric ultrasound, age is a major factor for calculation of GV.…”

Section: Introductionmentioning

confidence: 99%

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Differences in preoperative gastric ultrasound findings in elderly compared to the mid-aged surgical patients: A retrospective observational study

et al. 2023

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This study aimed to compare gastric ultrasound assessments between young and elderly patients, to determine whether the cross-section area (CSA) cutoff values for elderly and young patients should be different, and to suggest CSA cutoff values for elderly patients. This study evaluated the data of 120 patients who underwent elective surgery under general anesthesia between July 2019 and August 2020. Demographic and gastric ultrasound assessment data were retrieved. Patients were divided into the elderly group (n = 58, age: ≥65 years) and young group (n = 62, age: <65 years). The CSAs in the supine and right lateral decubitus positions (RLDP), semiquantitative 3-point Perlas grade (grades 0, 1, and 2), and gastric volume (GV) were determined. CSAs according to different Perlas grades were compared between the 2 groups. To compare normally and non-normally distributed continuous data, Student t test and the Mann–Whitney U test were used, respectively. Categorical data were compared using the chi-square test or Fisher exact test, as appropriate. The receiver operating characteristic (ROC) curves were built for the CSAs to predict pulmonary aspiration. The CSA cutoff values for predicting a high risk of pulmonary aspiration in both the groups were determined. Among patients with Perlas grade 0, the CSA supine ( P = .002) and CSA RLDP ( P = .002) were greater in the elderly group than in the young group. The specificity, positive predictive value, and accuracy of the CSA decreased when the CSA cutoff value for the young group was applied to the elderly group. The CSA cutoff values for the elderly group were: CSA supine , 6.92 cm 2 and CSA RLDP , 10.65 cm 2 . The CSA of the empty stomach was greater in elderly patients than in young patients. We suggest that the following CSA cutoff values should be used for predicting pulmonary aspiration risk in elderly patients: CSA supine , 6.92 cm 2 and CSA RLDP , 10.65 cm 2 .

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Section: Resultsmentioning

confidence: 90%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Differences in preoperative gastric ultrasound findings in elderly compared to the mid-aged surgical patients: A retrospective observational study

et al. 2023

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Observational study of the effect of preoperative consumption of different doses of carbohydrates before spinal surgery

Qiu,

Li,

et al. 2024

Preprint

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Objective To investigate the effects of two carbohydrate doses administered 2 hours prior to spinal surgery on the perioperative period of patients, aiming to add evidence to help optimize enhanced recovery after surgery (ERAS). Methods One hundred patients undergoing spinal surgery were divided into a 200 ml carbohydrate group (group A) and a 400 ml carbohydrate group (group B), with 50 patients in each group, according to the random number method. Patients in both groups consumed the carbohydrates (maltodextrin fructose drink) 2 hours before surgery. The gastric antral cross-sectional area (CSA) of the patients was recorded using gastric ultrasound at different time points. Gastric volume (GV), gastric emptying rate, and the proportion of patients with gastric emptying were calculated. Postoperative hunger, thirst, and anxiety scores were recorded on a visual analog scale (VAS). Postoperative nausea and vomiting (PONV) and length of stay (LOS) were recorded. Results The mean CSA and GV of both groups had returned to baseline at T4, with no significant difference from Tm (P > 0.05). Group B exhibited a lower gastric emptying rate than group A during period A1 (P < 0.05), while it was faster in group B during periods A2, A3, and A4 (P < 0.05). At T4, almost all patients had gastric emptying, the emptying rates of group A and group B being 92% and 88%, respectively. When comparing the blood glucose values before drinking (Tm) vs. after the operation (T5), there were no differences in either group (P > 0.05). The hunger and thirst scores of patients in group B were significantly lower than those in group A (P < 0.05). There was no significant difference in anxiety score, incidence of nausea and vomiting or length of stay (P > 0.05). Conclusion Oral carbohydrate drinks of 400 ml or 200 ml administered 2 hours prior to spinal surgery are safe for patients and can be incorporated into ERAS protocols to minimize postoperative complications and facilitate patient recovery. The larger 400 ml carbohydrate dose brings no increased risk of aspiration and effectively alleviates patient discomfort such as hunger and thirst.

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Ultrasound assessment of residual gastric volume in older adults undergoing staged-bilateral total knee arthroplasty after consuming carbohydrate-containing fluids: a prospective observational study

Abstract: This article has been accepted for publication and has undergone full peer review but has not been through the copyediting, typesetting, pagination, and proofreading processes, which may lead to differences between this version and the version of record.

Cited by 2 publications

References 33 publications

Differences in preoperative gastric ultrasound findings in elderly compared to the mid-aged surgical patients: A retrospective observational study

Differences in preoperative gastric ultrasound findings in elderly compared to the mid-aged surgical patients: A retrospective observational study

Observational study of the effect of preoperative consumption of different doses of carbohydrates before spinal surgery

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