Affiliation:
1. Department of Anaesthesia, Rajarajeshwari Medical College and Hospital, Bengaluru, Karnataka, India
Abstract
ABSTRACT
Background:
Prevention of pulmonary aspiration is an important aspect of anaesthesia practice. Strictly following the pre-operative fasting guidelines can pre-empt pulmonary aspiration in most patients undergoing elective surgeries. Ultrasonographic assessment of patients scheduled for laparoscopic cholecystectomy with symptomatic gall bladder disease has shown a higher incidence of a full stomach.
Aim:
The primary objectives of this study were to assess and compare gastric volume and contents in fasted patients undergoing elective laparoscopic cholecystectomy and other elective surgeries and to evaluate the relationship of fasting gastric volume and contents with other comorbidities and body mass index (BMI).
Materials and Methods:
On the day of surgery, hours of fasting were noted. Patients scheduled for laparoscopic cholecystectomy were in Group L, and patients scheduled for other surgeries were in Group O. Ultrasonography was performed before induction of anaesthesia in the pre-operative room by an experienced anaesthesiologist. The patients were classified based on the Perlas grading scale. To assess the risk of aspiration, the classification previously established by Ven de Putte and Perlas was used. Sixty patients were included in Group L and 60 patients in Group O.
Results:
The incidence of a full stomach was 3.33% in Group O and 20% in Group L. There was no significant association between BMI and gastric residual volume (GRV) in this study. There was no significant difference between GRV between diabetic and non-diabetic patients in Group L and Group O.
Conclusion:
Patients with gall bladder pathologies scheduled for cholecystectomy could have delayed gastric emptying; therefore, anaesthesiologists should be cautious, and bedside assessment tools such as ultrasound, which is easy and non-invasive, should be utilised to stratify the risk of aspiration in such patients.