Ultrasound assessment of gastric contents in children undergoing elective ear, nose and throat surgery: a prospective cohort study

Anaesthesia. 2017 Nov;72(11):1351-1356. doi: 10.1111/anae.14010. Epub 2017 Aug 14.

Abstract

Ultrasound examination of the gastric antrum allows reliable assessment of gastric contents and volume. Postoperative assessment of gastric contents before recovery from anaesthesia could help the physician to choose the most appropriate extubation technique after surgery in children. In this prospective observational study, we assessed whether significant changes occurred in gastric contents during the intra-operative period in children undergoing elective ear, nose and throat (ENT) surgery. Children aged between six months and 16 years were recruited consecutively. Ultrasound examination of the antrum was performed before induction of anaesthesia and at the end of surgery before tracheal extubation, and included quantitative and qualitative assessment of gastric contents. The mean (SD) gastric volume was 0.28 (0.30) ml.kg-1 before surgery and 0.27 (0.30) ml.kg-1 after surgery, p = 0.82. No solid contents were identified in the antrum, and the gastric volume was < 1.5 ml.kg-1 in all patients during both ultrasound examinations. Our results suggest that, after elective ENT surgery, children are not at risk of a full stomach before tracheal extubation, and that pulmonary aspiration of blood that may occur after elective ENT surgery is probably not related to regurgitation of ingested blood from the stomach.

Keywords: anaesthetic management; gastric volume; paediatrics; ultrasound.

Publication types

  • Observational Study

MeSH terms

  • Adolescent
  • Airway Extubation
  • Child
  • Child, Preschool
  • Cohort Studies
  • Elective Surgical Procedures / methods*
  • Fasting
  • Female
  • Gastrointestinal Contents / diagnostic imaging*
  • Humans
  • Infant
  • Male
  • Otorhinolaryngologic Surgical Procedures / methods*
  • Pneumonia, Aspiration / etiology
  • Postoperative Complications / etiology
  • Prospective Studies
  • Pyloric Antrum / diagnostic imaging
  • Stomach / diagnostic imaging*
  • Ultrasonography / methods*