Background and Goal of Study: Pulmonary aspiration of gastric content is a rare but serious complication of general anaesthesia. According to the Enhanced Recovery After Surgery (ERAS) guidelines, patients may receive a carbohydrate-rich drink up to 2 hours prior to planned surgery. Our hypothesis was that residual gastric volume in our ERAS colorectal patients would not exceed the safe limit of 1.5 mL/kg body weight 2 to 3 hours after ingestion of a standard preoperative drink.
Materials and Methods: Sixty-eight consecutive ERAS colorectal patients received 200 mL carbohydrate rich drink until 2 hours prior to operation. Two hours after ingestion of the drink a sonography of the gastric antrum was performed and residual gastric volume was calculated. Multiple regression analysis was used to study a relationship between gastric volume and demographic and behavioural parameters (age, BMI, ASA score and drink-to-scan time).
Results and Discussion: Mean residual gastric volume was 0.5 mL/kg body weight. Only in 4 patients (5.9%) residual gastric volume exceeded safe cut-off value of 1.5 mL/kg. In no patient aspiration nor regurgitation occurred neither on induction nor on emergence of general anaesthesia. The residual gastric volume showed significant negative correlation with age (p<0.05); no correlation with body-mass index, ASA physical status or time between drink and scan was found.
Conclusion(s): The ingestion of a clear fluid like carbohydrate rich drink in elective surgical patients up to 2 hours preoperatively is safe in terms of aspiration of gastric content and should probably be encouraged.

07 / Ultrasound assessment of preoperative gastric emptying in elective colorectal enhanced recovery after surgery (ERAS) patients