Year : 2022  |  Volume : 16  |  Issue : 3  |  Page : 355-360

Comparison of ultrasound-guided residual gastric volume measurement between diabetic and non-diabetic patients scheduled for elective surgery under general anesthesia

1 Department of Anaesthesiology and Critical Care, ABVIMS and Dr. RML Hospital, New Delhi, India
2 Department of Anaesthesiology, Pain Medicine and Critical Care, All India Institute of Medical Sciences, New Delhi, India
3 Department of Radiodiagnosis, ABVIMS and Dr. RML Hospital, New Delhi, India

Correspondence Address:
Sanjeev Sharma
Room No. 302, PGI Building, Department of Anaesthesiology and Critical Care, ABVIMS and Dr. RML Hospital, New Delhi
Login to access the Email id

Source of Support: None, Conflict of Interest: None

DOI: 10.4103/sja.sja_223_22

Rights and Permissions

Background and Aims: The presence of gastric content increases the risk of aspiration during general anesthesia. Diabetic patients have delayed gastric emptying; however, despite adequate fasting because of diabetic gastroparesis these patients have a high risk of aspiration. This study aimed to compare ultrasound-guided measurement of residual gastric volume between diabetic and non-diabetic patients scheduled for elective surgery under general anesthesia. Methods: This prospective observational study included 80 patients divided into two groups of 40 diabetic patients with a minimum of 8 years history of diabetes and 40 nondiabetic patients aged >18 years, American Society of Anesthesiologists' physical status I–II kept with similar fasting intervals. Before induction of general anesthesia, gastric ultrasound was performed using standard gastric scanning protocol to measure craniocaudal (CC) and anteroposterior (AP) diameters followed by calculation of antral cross-sectional area (CSA) and gastric volume in semi-sitting (SS) and right lateral decubitus (RLD) position using curved array probe. The gastric antrum volume (GV) was classified as Grade 0, 1, or 2, and risk stratification for aspiration was done. The nasogastric tube was inserted after induction of anesthesia to aspirate and compare the gastric content. Results: In the semi-sitting position, the mean CC and AP diameters were 16.38 ± 3.31 mm and 10.1 ± 2.53 mm in the non-diabetic group and 25.19 ± 4.08 mm and 15.8 ± 3.51 mm in the diabetic group, respectively. In RLD, CC was 1.91 ± 0.38 cm and AP was 1.19 ± 0.34 cm in the non-diabetic group as compared to the CC of 2.78 ± 0.4 cm and AP of 1.81 ± 0.39 cm in the diabetic group. The calculated CSA of 318.23 ± 97.14 mm2 and 4 ± 1.1 cm2 in diabetic were significantly higher than 133.12 ± 58.56 mm2 and 1.83 ± 0.83 cm2 of non-diabetic, in SS (p < 0.0001) and RLD (p < 0.0001) positions, respectively. The GV of 15.48 ± 11.18 ml in the diabetic group was significantly higher than (-) 9.77 ± 18.56 ml in the non-diabetic group (p < 0.0001). Despite the differences in CSA and GV between diabetic and non-diabetic groups, both groups showed a low gastric residual volume (<1.5 ml/kg). The gastric tube aspirate in the non-diabetic and diabetic groups was 0.3 ± 0.78 ml and 1.24 ± 1.46 ml, respectively, and was statistically significant (p = 0.0006). Conclusion: Patients with long-standing diabetes showed higher gastric residual and antral CSA when compared with non-diabetic patients. The clinical significance of these findings needs further evidence for the formulation of specific guidelines for diabetic patients.

Print this article     Email this article
 Next article
 Previous article
 Table of Contents

 Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
 Related articles
 Citation Manager
 Access Statistics
 Reader Comments
 Email Alert *
 Add to My List *
 * Requires registration (Free)

 Article Access Statistics
    PDF Downloaded294    
    Comments [Add]    

Recommend this journal