Incidence of Full Stomach in Patients Who Underwent Non-emergency Surgery at Patong Hospital

Abstract

Background: Pulmonary aspiration is a common respiratory complication during anesthesia and may result in severe morbidity when a large volume is aspirated, which is related to the amount of residual gastric contents. A full stomach is still encountered in patients undergoing elective surgery, due to misunderstanding of fasting guideline as well as other risk factors. Gastric ultrasonography is an accurate method for assessing the volume and characteristics of gastric contents.

Objectives: To determine the incidence of a full stomach in patients undergoing non-emergency surgery at Patong Hospital and to identify risk factors associated with a full stomach.

Methods: This prospective descriptive study included patients aged 18–70 years undergoing non-emergency surgery who gave history of completed the fasting regimen. Exclusion criteria were pregnancy >20 weeks, presence of a large intra-abdominal or pelvic mass above the umbilicus, BMI >35 kg/m2, and inability to lie in the right lateral decubitus position. Qualitative and quantitative assessments of the gastric antrum were performed using ultrasonography.

Results: A full stomach was identified in 19 of 79 patients (24.1 %). Among these, four patients had solid contents and fifteen had clear fluid greater than 1.5 mL/kg or >100 ml. Factors associated with a full stomach were obesity (BMI >30 kg/m2): adjusted OR 8.4 (95% CI 1.40–50.08; p=0.020) and ASA physical status 3: adjusted OR 10.9 (95% CI 2.10–56.86; p=0.005).

Conclusions: The incidence of a full stomach among non-emergency surgical patients at Patong Hospital was 24.1 %. Obesity and ASA physical status 3 were significant risk factors for a full stomach.