A Prospective Observational Study Using Abdominal Ultrasound to Compare Gastric Cross-sectional Area in Patients Fasting Overnight versus Patients Taking Carbohydrate Drinks 2 h before Onco-surgery Under General Anaesthesia

Background and Aims: Perioperative aspiration is a serious complication influenced by the volume and nature of gastric contents. Point-of-care ultrasound enables assessment of gastric volume (GV) and content to predict aspiration risk. This study aimed to compare gastric cross-sectional area (CSA) in the right lateral decubitus position (RLDP), GV, gastric volume per kg (GV/kg), Perlas grade and the incidence of GV/kg >1.5 mL/kg, as well as preoperative hunger and thirst scores between overnight-fasted patients and those given a carbohydrate drink 2 h before surgery. Methods: A prospective observational study was conducted in oncosurgical patients aged 18–70 years undergoing elective surgery. Patients who fasted overnight were in the nil per os group, and patients who took a carbohydrate-rich drink 2 h before surgery were in the non-nil per os group. Ultrasonographic examination was performed to find out the CSA in the RLDP and in the semisitting position, and GV and GV/kg were calculated. Qualitative assessment was done using Perlas grading. Preoperative hunger and thirst score was assessed using a numerical scale. Results: CSA (RLDP) was significantly lower in patients who consumed preoperative carbohydrate drinks (7.5 ± 0.64 vs 7.9 ± 0.93 cm 2 ; P = 0.007), though GV and GV/kg showed no significant difference ( P = 0.26 and P = 0.31, respectively). Five patients in this group had RLDP fluid (Perlas grading), while none in the fasting group did. Hunger and thirst scores were significantly lower with carbohydrate drinks ( P = 0.0001). Conclusion: We conclude that anaesthesiologists can safely follow the standard fasting guidelines, and administering carbohydrate drinks before surgery can enhance patient comfort.