Randomized Control Clinical Trial of Overnight Fasting to Clear Fluid Feeding 2 Hours Prior Anaesthesia and Surgery

Perioperative aspiration of gastric contents is a rare but serious complication of anaesthesia. Recent fasting guidelines recommend 2 h of fasting for clear fluids before surgery, to avoid aspiration but are often over looked in clinical practice. Our aim is to overcome these issues by using ultrasound to quantify gastric volume as our primary objective. Patients with ASA grade I with age group between 18 and 60 years undergoing elective surgery with general anaesthesia requiring tracheal intubation were randomized in overnight fasting group (group A) and 2-h fasting group with 200 ml of clear apple juice (group B). Ultrasound-guided gastric volume was calculated preoperatively, and gastric pH was measured immediately post-tracheal intubation using pH strip paper. In a total of 60 patients, the mean gastric volume by USG in group A is 29.7 ± 8.0 ml and group B is 19.2 ± 4.9 ml. The reduced gastric volume in group B is statistically significant (< 0.00001). The mean pH of gastric aspirate in group A is 1.4, and group B is 1.6 with statistically insignificant p value (p < 0.1268) which shows that pH in both the groups was almost same. The mean gastric volume in patients who had 200 ml of clear apple juice 2 h prior (group B) to non-abdominal surgery was lesser than patients who fasted overnight (group A). It supports the fasting guidelines which help in reducing the preoperative discomfort of long fasting hours and dehydration of patients, whereas the mean pH was almost the same for both the groups. Clinical trial registration: CTRI/2018/07/014851.