This study aimed to evaluate the effect of metoclopramide on preoperative gastric emptying in diabetic patients.
Perioperative aspiration of gastric contents is a rare but serious complication of anesthesia. Aspiration pneumonia is associated with significant morbidity, including prolonged mechanical ventilation, and carries a risk of mortality as great as 5%. Point-of-care (POC) gastric ultrasound has gained popularity in recent times. It has been adapted in the field of anesthesiology gradually to make the clinical decision before anesthetizing patients where the fasting status is uncertain and in emergency patients where surgery is mandated. Metoclopramide, a medication used for diabetic gastroparesis, is a cholinergic agent that acts by increasing the release of acetylcholine at the neuromuscular junction within the gastric wall. Further, metoclopramide has antidopaminergic properties that inhibit dopamine-induced gastric smooth muscle relaxation, and it also penetrates the blood-brain barrier and binds to medullary chemoreceptors.
Study Type
OBSERVATIONAL
Enrollment
60
Diabetic patients received a single IV dose of metoclopramide 10 mg (2 mL) administered 30-60 minutes prior to POC gastric ultrasound assessment, to allow for peak prokinetic effect.
Kafrelsheikh University
Kafr ash Shaykh, Kafrelsheikh, Egypt
Antral cross-sectional area
Antral cross-sectional area (CSA) was measured by Point-of-Care (POC) ultrasound (cm²). Antral CSA was calculated using the standard ellipse formula: Antral CSA (cm²) = π/4 × antero-posterior (AP) (cm) × cranio-caudal (CC) (cm)
Time frame: 30 minutes after drug administration
Gastric volume
Gastric volume (GV) was estimated using the validated formula described by Perlas et al.: GV (mL) = 27.0 + 14.6 × right lateral decubitus (RLD)-cross-sectional area (CSA)- 1.28 × Age
Time frame: 30 minutes after drug administration
Antral gastric grade
Qualitative grading of gastric content was performed as follows, using the validated Perlas classification: Grade 0 - empty antrum in both semi-sitting (SS) and right lateral decubitus (RLD) positions (estimated GRV ≤0 mL, minimal aspiration risk); Grade 1 - fluid visible in RLD position only \[estimated gastric residual volume (GRV) approximately 100-300 mL, low-to-intermediate risk\]; Grade 2 - fluid visible in both SS and RLD positions (estimated GRV \>300 mL, high aspiration risk).
Time frame: 30 minutes after drug administration
Fasting glucose
Post-intervention fasting serum glucose was measured.
Time frame: 30 minutes after drug administration
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