Degenerative Arthritis
Conditions
Brief summary
Aspiration of gastric contents during perioperative period is a grave complication with significant morbidity and mortality. Diabetic patients have a higher incidence of autonomic dysfunction, causing gastropathy. They are known to have gastroparesis and the consequent delayed gastric emptying which predisposes them to an increased risk of aspiration than the general population. Furthermore, other common factors can influence the gastric emptying rate, as for example, old age, pain, and the use of opioid analgesics. In the previous study, evidence of increased pain was reported in patients undergoing staged bilateral total knee arthroplasty, in whom the second operated knee had greater sensitivity (tertiary hyperalgesia) due to the surgical injury to the first operated knee. In the present study, we will evaluate the effect of old age, diabetes, surgical stress, pain, and the use of analgesics on the residual gastric volume in elderly patients undergoing staged-bilateral total knee arthroplasty.
Interventions
Ultrasound exam is done before the induction of spinal anesthesia. Three consecutive measurements of the anteroposterior (AP) and cranio-caudal (CC) diameters are performed. The cross-sectional area (CSA) of antrum is shown by the following formula: CSA = AP x CC x ㅠ/4. Antral area will correspond to the average of the three measures.
Sponsors
Seoul National University Bundang Hospital
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
65 Years to 85 Years
Healthy volunteers
No
Inclusion criteria
* Patients scheduled for staged bilateral total knee arthroplasty aged 65 to 85 years * American Society of Anestheiologist physical status classification 1, 2, and 3 * Body mass index \< 35 kg/cm2
Exclusion criteria
* Previous surgery of the upper gastrointestinal tract * Achalasia
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Volume of Gastric Contents | Less than one hour prior to surgery | A full stomach is defined as on containing a) solid or thick fluid content or b) 1.5 mL/kg of clear fluid. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Numerical rating pain scale | One hour prior to surgery, Postoperative 24 and 48 hour | Postoperative pain score (0 = no pain, 10 = very severe pain) |
| Rescue analgesics | Postoperative 24 and 48 hour | Amounts of the analgesics administered to manage the postoperative pain |
Countries
South Korea
Outcome results
None listed