Abstract PR417

Abstract

Background & Objectives: Gastric volumes of more than 0.4 ml/kg at induction of general anaesthesia is associated with increased risk of pulmonary aspiration. Prevention of pulmonary aspiration is one of the important aspects of safe anaesthetic practices and several measures have been proposed to reduce this risk. This prospective randomised double blind, placebo controlled trial was carried out to compare the effects of metoclopramide, octreotide and placebo on gastric volume when given as premedication prior to induction of anaesthesia. Materials & Methods: Forty five ASA I or II patients scheduled for elective surgery under general anaesthesia were randomly allocated into three groups. Group 1 received 50 ml of intravenous(IV) normal saline (placebo), Group 2 received 10 mg IV metoclopramide diluted in 50 ml saline, and Group 3 received 50 µg IV octreotide diluted in 50 ml saline. All study drugs were infused 30 minutes prior to induction of general anaesthesia. After endotracheal intubation or insertion of supraglottic device, a nasogastric tube size 14G was inserted into the stomach for collection of gastric content. Gastric volumes, blood sugar levels pre and post drug administration as well as the side effects of the studied drugs were recorded. Results: Metoclopramide decreased gastric volume significantly (p < 0.05; 95% CI for median difference: 1.1 – 6.7 ml) compared with both octreotide and saline. Octreotide however did not significantly alter gastric volume (p > 0.05; 95% CI for median difference: 5 – 32 ml) compared with placebo (saline). Mean sugar level was raised from 5.52 to 6.53 after octreotide administration, (p < 0.05). One patient experienced mild abdominal cramps with administration of octreotide. There was no incident of pre-induction nausea, vomiting or adverse drug reactions. Conclusion: Metoclopramide is found to be effective in reducing gastric volume, as compared to octreotide and placebo when given as premedication prior to general anaesthesia. There is no difference between placebo and 50 µg octreotide in reducing gastric volume in these patients.