Preoperative Glycemic Status Affects the Risk for Acid Aspiration Pneumonia in Elective Cesarean Delivery

Abstract

Recent studies have emphasized the importance of serum glucose in the regulation of gastrointestinal function. Larger volume and more acidic gastric residue secondary to the delayed gastric emptying resulting from hormonal and mechanical factors and the high levels of placentally derived gastrin have been documented in late pregnancies. Pulmonary aspiration syndrome continues to be a major concern in obstetric anesthesia because the morbidity and mortality associated with this complication increase with the volume and acidity of the gastric aspirate. In contrast to the many studies about the effects of hypoglycemia or hyperglycemia on gastric acid secretion and motor function, no studies have been conducted to determine the effects of glycemic status on the gastrin release and actual preoperative gastric contents especially in pregnant women. The purpose of this study was to investigate the effects of prophylactic 5% dextrose infusion during overfasting period without inducing hyperglycemia on preoperative serum gastrin concentration, gastric pH and volume in pregnant women undergoing elective cesarean delivery.