Accuracy of ultrasonographic measurement of gastric fluid volume in predicting the occurrence of nausea and vomiting during and after emergency cesarean section

Abstract

Objective To assess the accuracy of ultrasonographic measurement of gastric fluid volume in predicting the occurrence of nausea and vomiting during and after emergency cesarean section.Methods Seventyseven ASA Ⅰ-Ⅲ patients aged 18-35 yr weighing 66-87 kg undergoing emergency cesarean section were divided into 3 groups according to the preoperative gastric fluid volume:group A ≤ 0.4 ml/kg (n =21); group B 0.4-0.8ml/kg (n =34) and group C ＞ 0.8 ml/kg (n =22).Gastric fluid volume was calculated by Bouvet regression equation,based on antral area of the stomach measured with M-Turbo ultrasonography system (Somo Site Co.USA).Cesarean section was performed under combined spinal-epidural anesthesia with 0.4％ ropivacaine.BP,HR and SpO2 were measured and recorded after entering the operating room,at skin incision and at the end of operation.The occurrence of nausea and vomiting was recorded during operation and within 1 h after operation.Results There was no significant difference in hemodynamic variables among the 3 groups.The incidence of nausea was comparable among the 3 groups:33％ in group A,35％ in group B and 46％ in group C,while the incidence of vomiting was significantly higher in group C (46％) than in group A (10％) and group B (15％).Conclusion The incidence of vomiting is significantly higher during and within 1 h after emergency cesarean section in patients with preoperative gastric fluid volume ＞ 0.8 ml/kg,but the incidence of nausea is not related to preoperative gastric fluid volume. Key words: Postoperative nausea and vomiting; Cesarean section; Ultrasonography