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Effect of preoperative oral fluids on gastric volume and pH in postpartum patients
M Somwanshi1, A Tripathi, B Singh
1Department of Anesthesiology, Lady Hardinge Medical College and Smt. S.K. Hospital, New Delhi, India.
Insights
Postpartum patients can drink 150 ml of plain water two and a half hours before surgery without increasing the risk of aspiration syndrome. This study found no significant difference in gastric volume or pH in postpartum patients who drank water versus those who fasted.
Area of Science:
- Anesthesiology
- Obstetrics & Gynecology
Background:
- Fasting guidelines before surgery aim to minimize aspiration risk.
- The safety of preoperative oral fluid intake in postpartum patients is not fully established.
Purpose of the Study:
- To evaluate the effect of preoperative oral fluid intake on gastric volume and pH in postpartum patients.
- To compare these parameters with normally fasting postpartum and non-pregnant patients.
Main Methods:
- A study involving 60 patients (40 postpartum, 20 non-pregnant) undergoing sterilization.
- Patients were divided into three groups: 1) postpartum with 150 ml water 2.5 hours pre-op, 2) postpartum fasting, 3) non-pregnant fasting.
- Gastric volume and pH were measured after anesthesia induction.
Main Results:
- No statistically significant differences in mean gastric volume (approx. 22 ml) or pH (approx. 2.2) were observed among the three groups.
- The incidence of high-risk factors for acid aspiration syndrome (gastric volume > 25 ml and pH < 2.5) was also insignificant across groups.
Conclusions:
- Ingesting 150 ml of plain water 2.5 hours before surgery in overnight-fasted postpartum patients does not elevate the risk of aspiration syndrome.
- Current preoperative fasting protocols may be safely modified for postpartum patients regarding oral fluid intake.
Abstract:
The effect of preoperative oral fluids to postpartum patients on the gastric volume and pH was compared with normally fasting postpartum and non-pregnant patients undergoing sterilisation. Forty consecutive postpartum patients and twenty non-pregnant patients scheduled for sterilisation procedure were selected for the study. All patients were fasted overnight. Twenty postpartum patients were randomly allocated to receive 150 ml of plain water two and half hours before surgery (Group 1), while the remaining postpartum patients (Group 2) and non-pregnant patients (Group 3) continued their overnight fast as usual. After induction of anesthesia, gastric volume and pH was measured in all the patients. The mean gastric volume was found to be 21.9 +/- 8.49 ml in Group 1, 22.55 +/- 8.30 ml in Group 2 and 22.65 +/- 8.17 ml in Group 3. The mean pH was found to be 2.21 +/- 0.98 in Group 1, 2.18 +/- 0.88 in Group 2 and 2.12 +/- 1.02 in Group 3. The difference in the volume and pH in all the three groups was statistically insignificant. The difference in the incidence of patients with combined high risk factors of acid aspiration syndrome (gastric fluid volume > 25 ml and pH < 2.5) among the three groups was also insignificant. The authors conclude that ingestion of 150 ml of plain water approximately two and half hours before scheduled time of surgery in overnight fasted postpartum patients does not increase the risk of aspiration syndrome.