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Gastric emptying following Colles' fracture
D J Steedman1, M R Payne, J H McClure
1Department of Accident and Emergency Medicine, Royal Infirmary, Edinburgh, U.K.
Archives of Emergency Medicine
|September 1, 1991
Summary
Fasting patients before intravenous regional anaesthesia (IVRA) may not be necessary, as a Colles
Area of Science:
- Anesthesiology
- Pharmacokinetics
- Trauma Surgery
Background:
- Intravenous regional anaesthesia (IVRA) is generally safe, but local anesthetic toxicity can cause convulsions and loss of consciousness, leading to pulmonary aspiration.
- Patient fasting before IVRA is a common precaution to minimize aspiration risk, but its efficacy is questionable if painful injuries delay gastric emptying.
Purpose of the Study:
- To investigate the effect of a recent Colles' fracture on gastric emptying rates.
- To determine if fasting is a necessary precaution for patients undergoing IVRA following a Colles' fracture.
Main Methods:
- Utilized paracetamol absorption kinetics to measure gastric emptying rates in patients with a Colles' fracture sustained within 4 hours.
- Compared post-manipulation gastric emptying rates with baseline control values obtained during outpatient attendance.
Main Results:
- No statistically significant difference was observed in the rate of gastric emptying between patients with a recent Colles' fracture and control values.
- Gastric emptying is not significantly delayed by a recent Colles' fracture.
Conclusions:
- The common practice of fasting patients prior to IVRA may be unnecessary for those with a recent Colles' fracture.
- Eliminating the fasting requirement could reduce patient discomfort without increasing the risk of pulmonary aspiration.