Evaluation of the effect of preoperative carbohydrate-rich fluid administration on gastric volume and postoperative nausea and vomiting in pediatric patients

Preoperative fasting strategies in pediatric patients aim to avoid adverse situations caused by long fasting period and to prevent complications caused by inappropriate fasting period. Clear liquids have a shorter gastric emptying time than particulate liquids. Caloric content and volume determine the gastric emptying time of clear liquids. In this study, it has been determined that gastric emptying time for apple juice is shorter than water due to the caloric content of gastric emptying time. It was aimed to investigate whether it is short or not by gastric ultrasonography. One of the secondary aims of our study was to evaluate the relationship between gastric volume and nausea and vomiting. A total of 70 pediatric patients aged 4-18, who were planned to be operated under elective conditions by the pediatric surgeon, and who met the inclusion criteria, were included in the study. Patients were randomly assigned into two groups. The water group (n=35) and apple juice group (n=35) were given 5ml kg-1 water orally 2 hours before the surgery. Volume measurements were made by gastric ultrasonography after 6 hours of fasting (baseline value), 1 hour and 2 hours after drinking water or apple juice. Aspiration risk was determined according to the Perlas score. In the measurements made in both positions according to the basal volume value, water and apple juice were found to decrease the residual gastric volume after 1 hour or 2 hours. In RLD position measurements, preoperative administration of 5ml kg-1 carbohydrate-rich fluid reduces the residual gastric volume at the 2nd hour. A high baseline gastric volume or a low Perlas score of 0 was associated with postoperative vomiting. Prolongation of surgical procedure increases the rate of vomiting. We showed that administration of clear fluids 1 hour before and 2 hours before anesthesia did not cause a significant difference in gastric volume. Keywords: Gastric ultrasound, gastric volume, pediatric anesthesia, postoperative nausea vomiting, oral carbohydrate