Preoperative ultrasound assessment of gastric content in obese patients

Abstract

Background Gastric ultrasound is a simple bedside test that can be used for assessment of patients at risk of aspiration. Aim To compare gastric volume and content in obese with nonobese patients after 8-h fasting using gastric ultrasonography. Patients and methods This study was conducted on 100 patients, comprising 50 obese and 50 nonobese, of either sex, having American Society of Anesthesiologists status I–III, with age of at least 21 years, and with no other causes for delayed gastric emptying. Gastric ultrasound was performed by our co-author radiologist. Quantitative and qualitative assessment of antrum, time taken to complete the examination, and number of patients at risk were compared between the two groups. Moreover, we compared residual volume in supine position with right lateral decubitus in the same group. Results Obese patients had significantly higher gastric volume and total number of patients at higher risk of aspiration; however, both groups were comparable regarding volume/kg. In qualitative assessment, obese patients included lower number of patients with empty stomach and higher number with particulate or solid contents. In both groups, right lateral decubitus volume estimation was higher than supine position volume estimation. Conclusion A considerable percentage of fasted preoperative obese patients have risky gastric content, and ultrasound scanning is recommended.

Keywords

• gastric content
• gastric ultrasound
• obese
• preoperative
• residual gastric volume