Anesthesia
Conditions
Brief summary
The presence of gastric contents makes an aspiration event more likely , and as a result, preoperative fasting guidelines are designed to provide adequate time for gastric emptying in patients undergoing surgery. this study will be conducted to assess the gastric volume and content with the help of ultrasound in fasted pediatric patients scheduled for elective surgeries
Detailed description
it is unknown how many patients have gastric volumes that place them at increased risk of aspiration despite adequate fasting. There is a growing interest in the use of bedside ultrasonography to assess gastric content and volume. It has been suggested that the gastric antrum in particular can be assessed reliably by sonography. hence, this study will be conducted to assess the gastric volume and content with the help of ultrasound in fasted pediatric patients scheduled for elective surgeries which will help to detect accuracy of preoperative fasting hours.
Interventions
OTHERliberal fasting
preoperative fasting according to 6-4-0 regimen then qualitative and quantitative preoperative gastric ultrasound assessment will be done to evaluate the proportion of patients with risky stomach
OTHERstandard fasting
preoperative fasting according to 6-4-2 regimen then qualitative and quantitative preoperative gastric ultrasound assessment will be done to evaluate the proportion of patients with risky stomach
Sponsors
Tanta University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
SCREENING
Masking
SINGLE (Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
8 Years to 18 Years
Healthy volunteers
No
Inclusion criteria
* paediatric patients aged 6-12 years old * ASA physical status I and II * scheduled for elective surgeries * the anticipated duration of 30-60 min
Exclusion criteria
* parents' refusal * overweight or obesity * expected difficult airway management * increased abdominal pressure * diabetes mellitus * congenital diseases * GERD or esophageal disease * uncooperative patients, * mental retardation or neurological disease * upper airway surgeries.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| proportion of patients with a risky stomach. | immediately preoperative | bedside ultrasound to estimate the gastric volume in milliliter |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| fasting hours | the new preoperative fasting (6 hours for solids, 4 hours for milk, non-clear fluid or light breakfast, and 0 hours for clear fluids) | actual and prescribed preoperative fasting |
| type of last meal | last meal within 24 hours preoperative | last meal (heavy solid,light solid,non clear fluid,or clear fluid) |
| episodes of gastric regurgitation, vomiting , aspiration | during induction or emergence from anesthesia (within 30 minutes) | incidence of regurgitation, vomiting , aspiration if regurgitation happened patients will be followed up postoperative clinically and radiologically |
| gastric content quality | immediately preoperative | bedside ultrasound to determine the nature of gastric content (solid or fluid) |
| parents satisfaction | after PACU discharge (within 2 hours postoperative) | parents' satisfaction is evaluated using a 5-point Likert scale |
| cancellation | decision will be taken within 30 minutes preoperative | rate of surgery cancellation |
| adverse events | preoperative or postoperative | adverse events related to fasting duration |
| gastric volume | immediately preoperative (within 30 minutes) | quantitative gastric ultrasound assessment (gastric volume, volume/weight, antral cross sectional area) |
Countries
Egypt
Outcome results
None listed