Gastric POCUS as a Perioperative Risk Assessment Tool in Hospitalized Patients Receiving Methadone for Opioid Use...

Area of Science:

• Anesthesiology
• Gastroenterology
• Pharmacology

Background:

• Delayed gastric emptying increases perioperative pulmonary aspiration risk.
• Opioids and diabetes are known risk factors for delayed gastric emptying.
• Methadone patients represent an understudied population regarding gastric emptying.

Purpose of the Study:

• To assess delayed gastric emptying in patients taking methadone using gastric point-of-care ultrasound (POCUS).
• To evaluate the safety of overnight fasting for methadone patients before anesthesia.

Main Methods:

• A cross-sectional observational cohort study was conducted.
• Adult inpatients receiving methadone were scanned using gastric POCUS after an overnight fast.
• Gastric antral contents were assessed and measured using standardized methods.

Main Results:

• 57.9% of patients on methadone had high-risk stomachs despite overnight fasting.
• Longer fasting periods correlated with a lower risk stomach (p < .05).

Conclusions:

• Patients on methadone exhibit a higher risk of delayed gastric emptying.
• Overnight fasting may not be sufficient to ensure preoperative safety in this population.
• Gastric POCUS is crucial for risk-stratifying patients and optimizing preoperative assessment.