Clinical study of ultrasound monitoring gastric emptying and preventing reflux aspiration in elderly patients following strategy of enhanced recovery after surgery
WANG Chao1 LI Yongyi1 HUANG Yimin1 CHEN Zhenhua1 HU Siguang1 CAI Xingjian2
1. Department of Anesthesiology, Jiangmen Wuyi Hospital of Traditional Chinese Medicine, Guangdong Province,Jiangmen 529000, China;
2. Department of Anesthesiology, Kaiping Hospital of Traditional Chinese Medicine,Guangdong Province, Jiangmen 529300, China
Abstract:Objective To study and analyze the clinical effect of ultrasound monitoring gastric emptying and preventing reflux aspiration in elderly patients following enhanced recovery after surgery (ERAS) strategy. Methods From July to December 2020, a total of 60 elderly patients who underwent elective upper abdominal surgery in Jiangmen Wuyi Hospital of Traditional Chinese Medicine and Kaiping Hospital of Traditional Chinese Medicine were selected as the research subjects. According to random number table, they were randomly divided into a control group with 30 cases and a experimental group with 30 cases. The patients in the control group were asked to keep fasting state from 22:00 p.m. before operation. The patients in the experimental group were asked to drink 400 ml carbohydrate 2 hours before operation. After entering the anesthesia preparation room, the patients in the two groups were monitored by ultrasound for gastric emptying and the risk of reflux aspiration. The gastric volume, antral cross-sectional area, gastric volume to body mass ratio and the risk of reflux aspiration were compared between the two groups. Results There were no significant differences in gastric volume, antral cross-sectional area, gastric volume to body mass ratio and reflux aspiration risk between the two groups (P>0.05). Conclusion For the elderly patients who follow ERAS strategy, the ultrasound is useful in monitoring the gastric emptying and preventing the reflux aspiration.
王 超;李泳怡;黄逸敏;陈振华;胡思光;蔡兴建. 超声在遵循加速康复外科策略下监测高龄患者胃排空情况及预防反流误吸的临床研究[J]. 中国当代医药, 2022, 29(9): 51-54.
WANG Chao;LI Yongyi;HUANG Yimin;CHEN Zhenhua;HU Siguang;CAI Xingjian. Clinical study of ultrasound monitoring gastric emptying and preventing reflux aspiration in elderly patients following strategy of enhanced recovery after surgery. 中国当代医药, 2022, 29(9): 51-54.
American Society of Anesthesiologists Committee.Practice guidelines for preoperative fasting and the use of pharmacogic agent to reduce the risk of pulmonaryaspiration[J].Anesthesiology,2017,126(3):376-393.
Bolondi L,Bortolotti M,Santi V,et al.Measurement of gastric emptying by real time ultrasonography[J].Gastroenterology,1985,89(4):752-759.
[8]
Perlas A,Mitsakakis N,Liu L,et al.Validation of a Mathematical Model for Ultrasound Assessment of Gastric Volume by Gastroscopic Examination[J].Anesth Analg,2013,116(2):357-363.
[9]
陶伟荣.急诊手术患者术前胃排空及影响因素[D].苏州:苏州大学,2019.
[10]
Perlas A,Chan VW,Lupu CM,et al.Ultrasound Assessment of Gastric Content and Volume[J].Anesthesiology,2009,111(1):82-89.
Bataille A,Rousset J,Marret E,et al.Ultrasonographic evaluation of gastric content during labour under epidural analgesia:a prospective cohort study[J].Br J Anaesth,2014,112(4):703-707.
[12]
Jay L,Zieleskiewicz L,Desgranges FP,et al.Determination of a cut-off value of antral area measured in the supine position for the fast diagnosis of an empty stomach in the parturient:A prospective cohort study[J].Eur J Anaesthesiol,2017,34(3):1.
[13]
Sijbrandij LS,Op den Orth JO.Transabdominal ultrasound of the stomach: a pictorial essay[J].Eur J Radiol,1991,13(2):81-87.
[14]
Mendelson CL.The aspiration of stomach contents into the lungs during obstetric anesthesia[J].Am J Obstet Gynecol,1946,52(52):191-205.
Splinter WM.From the Journal archives:gastric fluid volume and pH in elective patients following unrestricted oral fluid until three hours before surgery[J].Can J Anaesth,2014,61(12):1126-1129.