The effects of oral fluid intake an hour before cesarean section on regurgitation incidence

The fear of aspiration of gastric contents and its life-threatening disadvantages in patients have encouraged many medical practitioners to follow conservative policies for clear fluid/liquid and solid intake from midnight to the time of surgery. These policies have been pursued more severely in case of pregnant women, leading the physicians to follow "nil per os" policy. The aim of this study was to determine and compare the incidence of regurgitation in two groups of pregnant women during general anesthesia for cesarean section, with standard fasting policy and taking clear fluid an hour prior to the induction of anesthesia.

This clinical trial was conducted for a period of 21 months in Nik-Nafs Maternity Hospital of Rafsanjan. The pregnant women who were candidates for elective cesarean section were registered for the study. All women fasted from midnight, and then were randomly assigned to one of the two groups. Those in the case group received 150 ml of clear liquid containing 10% carbohydrate about an hour before the induction of anesthesia. The occurrence of regurgitation was assessed by inserting the turnsole paper into the pharynx. Finally, the data of 411 cases were analyzed by descriptive methods.

There was one case of regurgitation (0.69%) in the control group and one case (0.36%) in the case group, and no case of aspiration.

There was no evidence to suggest that taking clear fluids about 1 hr before cesarean section will increase the risk of regurgitation. It confirms the safety of following more flexible fasting policies preoperatively, in addition to oral fluid intake, in case of parturients.