Does 360 ml of apple juice ingested before elective surgery worsen gastric volume and acidity in patients given acid aspiration prophylaxis?

STUDY OBJECTIVE

To evaluate whether 360 ml of oral clear liquids consumed within 4 hours of elective surgery worsens gastric volume and acidity in patients given acid aspiration prophylaxis.

DESIGN

Randomized, unblinded study.

SETTING

Main operating room at a U.S. military hospital.

PATIENTS

Eighty-three adult inpatients scheduled to receive general anesthesia for elective surgery.

INTERVENTIONS

Nineteen patients (Group 1) were given 150 mg of oral ranitidine (two doses), 10 mg of metoclopramide, and 360 ml of apple juice 3 hours before the scheduled start of surgery. Thirty-four patients (Group 2) fasted before surgery but received acid aspiration prophylaxis identical to that given to Group 1. Twenty-three additional patients (Group 3) received no oral fluids or acid aspiration prophylaxis before surgery.

MEASUREMENTS AND MAIN RESULTS

The residual gastric volume (RGV) and the pH of Group 1 patients were compared with measurements obtained in the two groups of patients who fasted. RGV measurements in Group 1 (14 +/- 3 ml) were similar to those in Group 2 (11 +/- 2 ml) and were significantly less than (p less than 0.05) those in Group 3 (26 +/- 4 ml). Gastric pH was significantly higher (p less than 0.001) in Group 1 (5.16 +/- 0.69) and Group 2 (5.78 +/- 0.43) than in Group 3 (1.97 +/- 0.27).

CONCLUSIONS

Three hundred and sixty ml of apple juice consumed within 4 hours of elective surgery by patients given ranitidine and metoclopramide did not worsen gastric volume and acidity.