Administering 150 ml of water 2 hours before surgery, with or without intramuscular morphine, significantly decreased residual gastric volume compared to overnight fasting (p<0.05).
RCT (n=150)
Randomized (3 groups)
Does oral fluid intake 2 hours before surgery, with or without premedication, affect residual gastric volume and pH in elective surgical patients?
Allowing 150 ml of water 2 hours before elective surgery significantly decreases residual gastric volume compared to overnight fasting, and is safe even when followed by intramuscular morphine.
p-value: p=<0.05
The effect of oral fluids before operation, followed by intramuscular morphine, on gastric volume and pH was examined in 150 elective surgical patients, ASA physical status 1 and 2, who were randomly assigned to one of the three groups of 50 each. Group 1 (control) continued their overnight fast; patients in Groups 2 and 3 received 150 ml water 2 hours before the scheduled time of surgery. Patients in Group 3 received intramuscular morphine 0.15 mg/kg and promethazine 0.5 mg/kg one hour before operation. The residual gastric volume was obtained by suction and its volume and pH measured immediately after induction of anaesthesia. Statistically significant (p less than 0.05) decrease in residual gastric volume was observed in Groups 2 and 3 as compared to Group 1. However, the difference between these two groups was not statistically significant. There was no statistically significant difference in pH among the three groups. Overnight fluid fasting is not justified in elective surgical patients. Morphine can be safely given one hour before surgery in patients who have received water (150 ml) 2 hours before operation.
Agarwal et al. (Tue,) conducted a rct in Elective surgery (n=150). Water with or without morphine and promethazine vs. Overnight fast was evaluated on Residual gastric volume and pH (p=<0.05). Administering 150 ml of water 2 hours before surgery, with or without intramuscular morphine, significantly decreased residual gastric volume compared to overnight fasting (p<0.05).