Comparative ultrasound-guided assessment of gastric volume between diabetic and non-diabetic patients posted for elective surgery—a prospective, observational, correlation study

Abstract

Abstract Background Perioperative aspiration of gastric contents is a serious complication and its severity depends upon the gastric volume and nature of the aspirate. Diabetic patients are more prone for aspiration because of delayed gastric emptying. USG-guided gastric examination can help in aspiration risk assessment by identifying the nature and volume of the gastric contents. This prospective observational study compared, USG-guided gastric contents and volume in fasting diabetic and non-diabetic patients posted for elective surgery under general anesthesia. Based on the history of diabetes mellitus (DM), 50 patients were divided into two groups, i.e., group A (diabetic for > 5 years, n = 25) and group B (non-diabetic, n = 25). After standard fasting period of 8 h, bedside ultrasound was conducted to assess gastric antral cross-sectional area, gastric volume and contents. Results The mean gastric antral cross-sectional area (3.96 ± 2.07 versus 2.96 ± 1.88, P value 0.08), mean gastric volume (17.88 ± 19.48 versus 9.72 ± 12.29, P value 0.083) and the mean gastric volume per kg body weight (0.16 ± 0.374 versus 0.04 ± 0.20, P value 0.164) after 8 h fasting were higher in diabetics as compared to non-diabetics, but were statistically insignificant. Conclusions Diabetic patients had comparatively slower gastric emptying and hence higher mean effecting gastric volume and gastric volume/kg body weight, after fixed hours of fasting. However, no patient had gastric volume/kg body weight > 1.5 ml/kg or presence of any solid food was visualized in any of the groups. Hence, the fixed 8 h fasting guarantees the safety from the risk of aspiration in diabetic and non-diabetic adult population.

Keywords

• Aspiration
• Diabetes
• Diabetic gastroparesis
• Gastric emptying
• Point of care anesthesia
• POCUS