Ultrasonographic Gastric Emptying In Paediatric Patients After Fasting Before Operation

Objective: To evaluate the volume of gastric contents in children using ultrasound and verify the safety of fasting.Methods: Two hundred paediatric patients who were younger than 60 months old,ASAⅠorⅡand were undergoing elective surgery were randomly divided into group A or group B,with 100 subjects in each group.The patients in group A were subjected to the following preoperative fasting guidelines: a fasting period lasting 6 hours,and the consumption of no more than 300 ml of glucose liquid at a dose of 5 ml.kg-1 2 hours before surgery.The patients in group B fasted for 6 hours.Ultrasound was used to detect GAA(gastric antral area)in the paediatric patients before surgery,then the GFV(gastric fluid volume)and the GFVw(body weight-corrected gastric fluid volume)were calculated.The type of operation,vital signs(heart rate,systolic / diastolic blood pressure),operation time were recorded and complications(vomiting,thirst,hunger)during the perioperative period were recorded.Results: Two hundred patients were enrolled,and 182 patients completed the study.Ninety patients completed the study in group A,84 were male and 6 were female.Ninety-two patients completed the study in group B,85 were males and 7 were females.The means±SD of GAA,GFV,and GFVw in group A were 199.63±83.72 mm2(95%CI:182.09–217.16),2.61±3.87 ml(95% CI: 1.80–3.42)and 0.16±0.26 ml.kg-1(95% CI:0.10–0.21),respectively.The means±SD of GAA,GFV,and GFVw in group B were283.00±105.50 mm2(95% CI: 258.97–306.69),5.15±4.35 ml(95% CI: 4.06–6.02),and0.36±0.30 ml.kg-1(95% CI: 0.28–0.42).respectively.GAA,GFV,and GFVw were lower in group A than in group B(P<0.001).The incidences of thirst and hunger when the children entered the operation room were lower in group A than in group B,theincidence of thirst 6 h after the operation was lower in group A than in group B(P<0.05).There were five instances of vomiting in the two groups during the perioperative period;two instances of vomiting occurred during the 6 h after surgery in both groups,and one instance of vomiting occurred during fasting in group B.There were no statistically significant differences in the incidence of vomiting during the perioperative period and the hunger 6 h after the operation between the two groups(P>0.05).There was no statistically significant difference between the two groups in the heart rate and blood pressure(P>0.05).There was no statistically significant difference between the two groups in operation type and operation time(P>0.05).Conclusion: Clear fluids(5ml/kg,total ≤300ml)ingested 2 h before surgery was safe,it reduced the gastric volume,decreased complications(thirst,hunger)of preoperative and thirst 6 hours after the operation in child.Certainly,it could promote gastric emptying in paediatric patients.