Department of Anesthesiology and Pain Medicine, Seoul National University Bundang Hospital, 82, Gumi 173, Bundang, Seongnam, Gyeonggi, 13620, Republic of Korea.
Can J Anaesth. 2022 Sep;69(9):1160-1166. doi: 10.1007/s12630-022-02262-9. Epub 2022 Apr 21.
The aim of this study was to evaluate the safety of drinking carbohydrate-containing fluids two hours prior to surgery in older adults using ultrasonography.
We conducted a nonrandomized and noninferiority comparative study in 60 patients aged over 65 yr who were scheduled for total knee arthroplasty. Patients who were fasted from midnight (fasting group) or who drank 400 mL of a carbohydrate-containing fluid (carbohydrate ingestion group) two hours prior to surgery were matched for age, sex, and body mass index. We measured the cross-sectional area (CSA) of gastric antrum using ultrasound and estimated the gastric fluid volume as the study's primary outcome measure. The noninferiority margin (δ) for the mean difference was predefined as 50 mL. The secondary outcome measures included CSA of the antrum and qualitative gastric volume.
The mean (standard deviation) gastric volume was not significantly different between the fasting group and the carbohydrate ingestion group (30.2 [25.4] mL vs 28.4 [35.8] mL; each group, n = 30; P = 0.81). The mean difference in gastric volume was -1.9 mL (95% confidence interval [CI], -17.9 to 14.2), and the upper limit of the 95% CI was lower than the prespecified noninferiority limit (δ = 50 mL). Secondary outcomes were not significantly different between the two groups.
Drinking of carbohydrate-containing fluid two hours prior to surgery was noninferior to overnight fasting with respect to residual gastric volume at induction of anesthesia in healthy older adults who undergoing total knee arthroplasty.
ClinicalTrials.gov (NCT04514380); registered 14 August 2020.
本研究旨在使用超声评估老年患者术前两小时饮用含碳水化合物液体的安全性。
我们对 60 名年龄在 65 岁以上拟行全膝关节置换术的患者进行了一项非随机、非劣效性比较研究。禁食至午夜的患者（禁食组）或术前两小时饮用 400ml 含碳水化合物液体的患者（碳水化合物摄入组），按年龄、性别和体重指数匹配。我们使用超声测量胃窦横截面积（CSA），并将胃液体量估计作为研究的主要观察指标。平均差值的非劣效性边界（δ）预设为 50ml。次要观察指标包括胃窦 CSA 和定性胃容量。
禁食组和碳水化合物摄入组的胃容量平均值（标准差）无显著差异（分别为 30.2 [25.4]ml 和 28.4 [35.8]ml；每组 n=30；P=0.81）。胃容量的平均差值为-1.9ml（95%置信区间[CI]，-17.9 至 14.2），95%CI 的上限低于预设的非劣效性限（δ=50ml）。两组的次要结局无显著差异。
与术前禁食过夜相比，健康老年全膝关节置换术患者术前两小时饮用含碳水化合物液体在诱导麻醉时胃残留量方面无差异。
ClinicalTrials.gov（NCT04514380）；注册于 2020 年 8 月 14 日。
