Gastric Residual Volume and Aspiration Risk Following Intravenous Metoclopramide in Fasted Diabetic Patients Undergoing Elective Surgery

Ultrasonographic Assessment of Preoperative Gastric Residual Volume and Aspiration Risk Following Intravenous Metoclopramide in Fasted Diabetic Patients Undergoing Elective Surgery Under General Anesthesia: A Prospective Non-Randomized Controlled Comparative Study

This study aimed to evaluate the effect of metoclopramide on preoperative gastric emptying in diabetic patients.

Perioperative aspiration of gastric contents is a rare but serious complication of anesthesia. Aspiration pneumonia is associated with significant morbidity, including prolonged mechanical ventilation, and carries a risk of mortality as great as 5%.

Point-of-care (POC) gastric ultrasound has gained popularity in recent times. It has been adapted in the field of anesthesiology gradually to make the clinical decision before anesthetizing patients where the fasting status is uncertain and in emergency patients where surgery is mandated.

Metoclopramide, a medication used for diabetic gastroparesis, is a cholinergic agent that acts by increasing the release of acetylcholine at the neuromuscular junction within the gastric wall. Further, metoclopramide has antidopaminergic properties that inhibit dopamine-induced gastric smooth muscle relaxation, and it also penetrates the blood-brain barrier and binds to medullary chemoreceptors.

Inclusion Criteria:

• Age from 18 to 65 years old.
• Both sexes.
• American Society of Anesthesiologists (ASA) physical status I-II.
• Underwent elective surgery.

Exclusion Criteria:

• Patients taking drugs that affect gastric motility.
• Patients with renal failure.
• Hypothyroidism.
• Obesity [body mass index (BMI) > 30kg/m2].
• Connective tissue disorders.
• History of gastrointestinal surgery.
• Those with steroid-induced hyperglycemia.
• Pregnancy.