Comparative Ultrasound Assessment of Gastric Volume between Apple Juice and Water Ingestion 2 Hours before General Anesthesia in Elective Surgery: a Prospective Randomized Controlled Trial

Abstract

Introduction: Clinical guidelines recommend clear fluid ingestion 2 h before general anesthesia in elective surgery. The study is aimed to compare the antral cross-sectional area, gastric volume (GV), and weight corrected gastric volume between apple and control groups by ultrasonography assessment. Methods: A prospective randomized controlled trial in 60 elective surgical patients scheduled for general anesthesia with endotracheal intubation technique was randomly assigned into 2 groups. A group ingested 200 mL of apple juice and C group ingested 200 mL of pure water 2 h before general anesthesia. GV assessed before ingestion, at 10 min, 1 and 2 h afterward by ultrasound. Numeric rating scale (NRS) of thirst, hunger, anxiety, and fatigue were assessed before ingestion and 2 h after ingestion. Sodium and blood glucose level were measured at 2 h. Complications were recorded. Results: At 2 h after drinking, GV of group A and C was 48.8±30.1 and 50.8±21.3 mL, respectively. There was not statistically significant between the two groups. GV maximum increased at 10 min and returned to baseline at 2 h in both groups. NRS of thirst, hunger and fatigue were significantly diminished in both groups at 2 h after ingestion. Blood sodium and glucose levels were not different between group A and C. Pulmonary aspiration did not occur. Conclusion: GV in patients receiving 200 mL of apple juice and water 2 h before general anesthesia in elective surgery was not different. Thirst, hunger and fatigue scores can diminish after ingestion.