Effect of acute cigarette smoking on gastric contents in regular smoker volunteers. A prospective randomized cross-over study.
BACKGROUND
The authors sought to assess the effect of acute smoking on gastric contents in regular smoker volunteers. The primary endpoint was the variation in antral area during the 120-min study period after cigarette smoking.


METHODS
Regular smoker volunteers were included in this prospective randomized single blind cross-over study. Volunteers attended two separate study sessions: Control and Smoking sessions. The study started with an initial ultrasound measurement of the antral area, immediately followed by a 30-min periods of waiting (Control session) or of two-cigarettes smoking (Smoking session). Ultrasound measurements of the antral area were then performed 30, 60, 90 and 120 min after the initial ultrasonography, allowing for the calculations of the variation rates in antral area during the periods 0-30, 0-60, 0-90 and 0-120 min in both sessions.


RESULTS
The variation in antral area during the period 0-120 min was equivalent in both sessions, as the difference in the variation rates between both sessions was -1.2%, with 90% confidence interval of the difference including 0 and lying entirely within the range of equivalence of -10% to 10%. No equivalence was found for the periods 0-30, 0-60 and 0-90 min, because of a non-significant decrease in antral area in the Smoking sessions during these periods.


CONCLUSIONS
Preoperative acute smoking did not affect the variation in the gastric volume in regular smoker volunteers during the study period. These results allow for the suggestion that acute preoperative smoking does not probably change the risk of pulmonary aspiration of gastric contents in healthy regular smokers.


BACKGROUND
NCT 02080598.
Department of Anaesthesia and Intensive Care, Hospices Civils de Lyon, Édouard Herriot Hospital, 5, place d'Arsonval, 69003 Lyon, France.
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Lazaar
Department of Anaesthesia and Intensive Care, Hospices Civils de Lyon, Édouard Herriot Hospital, 5, place d'Arsonval, 69003 Lyon, France.
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Boselli
University of Lyon, Claude Bernard Lyon 1 University, 43 boulevard du 11 Novembre 1918, 69100 Villeurbanne, France Department of Anaesthesia and Intensive Care, Hospices Civils de Lyon, Femme Mère Enfant Hospital, 59, boulevard Pinel, 69500 Bron, France.
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Chassard
University of Lyon, Claude Bernard Lyon 1 University, 43 boulevard du 11 Novembre 1918, 69100 Villeurbanne, France Department of intensive care, Hospices Civils de Lyon, Lyon Sud Hospital, 165, chemin du Grand Revoyet, 69310 Pierre-Bénite, France.
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Allaouchiche
Department of Anaesthesia and Intensive Care, Hospices Civils de Lyon, Femme Mère Enfant Hospital, 59, boulevard Pinel, 69500 Bron, France Inserm, U1032, LabTau, 151, cours Albert Thomas, 69003 Lyon, France lionel.bouvet@chu-lyon.fr.
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Bouvet
D000328:Adult; D000704:Analysis of Variance; D018592:Cross-Over Studies; D005260:Female; D005746:Gastric Emptying / Q000187:drug effects*; D005766:Gastrointestinal Contents / Q000187:drug effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011706:Pyloric Antrum / Q000000981:diagnostic imaging*; D016037:Single-Blind Method; D012907:Smoking / Q000009:adverse effects*; D014463:Ultrasonography; D055815:Young Adult
anaesthesia, general; gastrointestinal contents; smoking; volunteers