Gastric Ultrasound, Point of Care Ultrasound, Cannabis Use
Conditions
Keywords
cannabis, gastric ultrasound
Brief summary
The aim of this study is to perform bedside gastric point of care ultrasound (POCUS) exams to assess the gastric volume and content (clear liquids vs solid food) perioperatively in patients who report cannabis use.
Detailed description
Cannabis use in the United States has continued to increase in recent years, particularly in the adult population. Ease of access through legalization paired with improved public perception has contributed to the uptick in cannabis use. The subset of cannabis users suffering from pain who present for surgery pose a risk for perioperative aspiration due to the slowing of gastric motility due to cannabis use. There is currently no adapted NPO guideline to account for cannabis use. Gastric Ultrasound (GUS) can be used as a bedside tool for assessing a patient's stomach contents and risk of aspiration. GUS can identify whether a patient's stomach is empty or filled with clear liquid, thick liquid, or solid food. The volume of the stomach can be accurately calculated if there is clear liquid content. A full stomach is categorized as those with solid or thick liquid content or with clear liquid measuring more than 1.5 ml/kg body weight. As GUS is noninvasive and does not pose risk to patients, it is a useful tool assessing aspiration risk in the preoperative period.
Interventions
A gastric ultrasound is a simple, fast, non-invasive bedside diagnostic test that provides a qualitative and quantitative assessment of gastric contents. There are no known risks of a gastric ultrasound exam.
Sponsors
Hospital for Special Surgery, New York
Study design
Observational model
COHORT
Time perspective
CROSS_SECTIONAL
Eligibility
Sex/Gender
ALL
Age
18 Years to 99 Years
Healthy volunteers
No
Inclusion criteria
* Any patient reporting preoperative cannabis usage within 1 month of surgery date
Exclusion criteria
* Patient refusal to participate * Patient with gastric bypass or any other gastric surgery * Large hiatal hernia * Patients with large ascites * Patients on peritoneal dialysis * Emergency surgery * Pre-existing diagnosis of gastroparesis * Parkinson's disease * Diabetes * Currently taking metformin * Chronic kidney disease stage 3 or higher * Creatinine ≥ 1.2 * Esophageal surgery * Currently taking GLP1 agonist medication
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Incidence of delayed gastric emptying | This will be measured pre-operatively in the holding room area. | A full stomach on gastric ultrasound is defined by the presence of either solid food, thick liquids, or a specific volume (\>1.5 ml/kg) of clear liquids on gastric ultrasound. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Nothing by mouth (NPO) intervals | This will be measured pre-operatively in the holding room area. | Measure the NPO interval after last solid food and liquid consumption |
| Presence of gastric peristalsis | This will be measured pre-operatively in the holding room area. | Gastric peristalsis will be graded as absent, slow, or normal on gastric ultrasound |
| Time interval since last cannabis use | This will be measured pre-operatively in the holding room area. | Measure the time from last cannabis consumption to the time the gastric ultrasound was performed |
Countries
United States
Outcome results
None listed