Gastric Volumes by US in Term Parturients Undergoing CS With and Without Metoclopramide

Comparison of Gastric Volumes by Gastric Ultrasound in Term Parturients Undergoing Scheduled Elective Cesarean Delivery With and Without Metoclopramide

Our objective is to compare gastric volumes (mL) between women who receive metoclopramide versus placebo prior to scheduled cesarean delivery in appropriately fasted patients. If metoclopramide is found not to reduce gastric volumes this would inform future practice guidelines for obstetric anesthesia, which currently recommends metoclopramide administration prior to cesarean deliveries.

We hypothesize that metoclopramide given to women with appropriate fasting prior to cesarean delivery does not result in any clinically significant reduction in gastric volume (mL) and therefore does not provide any additional benefit for aspiration prophylaxis but may expose patients to unnecessary side effects. A secondary objective will be to evaluate if gastric volume is a significant predictor of intraoperative nausea and vomiting.

Inclusion Criteria:

• Healthy (ASA Physical Status 2)
• Age >18 years old
• Non-obese (BMI <40 kg/m2)
• Age >18 years
• Term (>37 week)
• Non-laboring parturient
• Single gestation
• Scheduled for a cesarean delivery and NPO

Exclusion Criteria:

• Systemic disease such as diabetes mellitus (type 1 or 2)
• Multiple gestation
• Abnormality of upper GI tract
• History of GI tract related surgical procedures
• Use of gastric motility medications
• Active labor
• Renal impairment (creatinine >2)
• Non-English speaking
• Cognitively impaired
• History of QT prolongation
• Use of general anesthesia