title: Ultrasound assessment of gastric volume in children after drinking carbohydrate-containing fluids.
abstract: BACKGROUND
  Gastric ultrasound is a valid tool for non-invasive assessment of the nature and volume of gastric contents in adults and children. Perioperative fasting guidelines recommend oral carbohydrates up to 2 h before elective surgery. We evaluated gastric volume in children using ultrasound before and after drinking carbohydrate fluids before surgery.
  
  
  METHODS
  Paediatric patients younger than 18 yr old undergoing elective surgery were enrolled. Initial ultrasound assessment of gastric volume was performed after fasting for 8 h. Two hours before surgery, patients were given carbohydrate drinks: 15 ml kg(-1) for patients younger than 3 yr old and 10 ml kg(-1) for those more than 3 yr old. Before induction of general anaesthesia, the gastric volume was reassessed. Parental satisfaction scores (0=totally satisfied, 10=totally dissatisfied) and complications were recorded.
  
  
  RESULTS
  Of the 86 enrolled patients, 79 completed the study; three refused to ingest the requested volume, and surgery was delayed for more than 2 h in four patients. The mean (sd) of the initial and second ultrasound measurements were 2.09 (0.97) and 1.85 (0.94) cm(2), respectively (P=0.01; mean difference 0.24 cm(2), 95% confidence interval 0.06-0.43). The median (interquartile range) satisfaction score was 2.4 (0-6). Two instances of postoperative vomiting and one instance of postoperative nausea occurred.
  
  
  CONCLUSIONS
  Carbohydrate fluids ingested 2 h before surgery reduced the gastric volume and did not cause serious complications in paediatric patients. Parents were satisfied with the preoperative carbohydrate drink. Children may benefit from drinking carbohydrate fluids up to 2 h before elective surgery.
  
  
  BACKGROUND
  cris.nih.go.kr (KCT0001546).
authors.affiliation: Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, #101 Daehak-ro, Jongno-gu, 03080, Seoul, Republic of Korea.
authors.forename: I-K
authors.initials: IK
authors.lastname: Song
authors.affiliation: Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, #101 Daehak-ro, Jongno-gu, 03080, Seoul, Republic of Korea.
authors.forename: H-J
authors.initials: HJ
authors.lastname: Kim
authors.affiliation: Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, #101 Daehak-ro, Jongno-gu, 03080, Seoul, Republic of Korea.
authors.forename: J-H
authors.initials: JH
authors.lastname: Lee
authors.affiliation: Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, #101 Daehak-ro, Jongno-gu, 03080, Seoul, Republic of Korea.
authors.forename: E-H
authors.initials: EH
authors.lastname: Kim
authors.affiliation: Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, #101 Daehak-ro, Jongno-gu, 03080, Seoul, Republic of Korea.
authors.forename: J-T
authors.initials: JT
authors.lastname: Kim
authors.affiliation: Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, #101 Daehak-ro, Jongno-gu, 03080, Seoul, Republic of Korea dami0605@snu.ac.kr.
authors.forename: H-S
authors.initials: HS
authors.lastname: Kim
mesh_terms: D000768:Anesthesia, General; D001628:Beverages; D002241:Carbohydrates / Q000009:adverse effects / Q000494:pharmacology*; D002648:Child; D002675:Child, Preschool; D017558:Elective Surgical Procedures; D005215:Fasting; D005260:Female; D005766:Gastrointestinal Contents; D006801:Humans; D007223:Infant; D008297:Male; D010290:Parents; D017060:Patient Satisfaction; D020250:Postoperative Nausea and Vomiting / Q000453:epidemiology; D013270:Stomach / Q000000981:diagnostic imaging*; D014463:Ultrasonography
chemical_list: D002241:Carbohydrates
keywords: anaesthesia, paediatric; measurement techniques, ultrasound; metabolism, fasting; surgery, preoperative period