Anesthesia & Pain Research

Abstract

Impact of Bedside Gastric Ultrasonography in the Daily Routine of Anesthesiology: An Observational Study

Hamann Hauke, Jensen Hanne I, Kuhn Jacob, Martinsen Kristian R

Background: Pulmonary aspiration is a serious complication of anesthesia. For prevention, fasting guidelines have been made, but they do not apply to acute patients or patients with certain conditions. In addition to known prevention, gastric ultrasonography is believed to help to quantify the amount of gastric content and predict the risk for pulmonary aspiration. In this study, changes in anesthesia procedure after gastric ultrasound were investigated.

Aims: To investigate if the use of preoperative gastric ultrasound in the normal daily routine has consequences for how we anesthetise our patients. To contribute to creating recommendations for indications of gastric ultrasound.

Methods: In an observational study 96 pre- and postoperative patients were gastric ultrasound scanned in order to evaluate their gastric content before urgent and elective surgery and before transfer from the Recovery Unit to the General Ward. On a standardised sheet, the amount and texture of the gastric content was registered and the risk
for pulmonary aspiration was predicted. Every change in anesthesia strategy was documented.

Results: The examination found 16 patients (18%) with an amount of gastric content corresponding to a high risk of pulmonary aspiration even in elective, non-risk patients. The anesthetic management for 23 patients (25%) was changed after gastric ultrasound. None of the investigated patients had pulmonary aspiration.

Conclusion: Gastric ultrasound may be a valuable tool to help to investigate aspiration risk in order to plan the best anesthetic management for every patient.

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