Abstract
BackgroundSurgical patients are asked to fast for a sufficient duration to ensure that the amount of residual liquid in the stomach is within the safe range, thereby reducing the risk of gastric reflux perioperatively. The authors hypothesized that subjective hunger numerical rating scale (NRS) score could also help assess the process of gastric emptying and determine the amount of fluid remaining in the stomach.MethodsThe current study consisted of healthy volunteers recruited by advertisement and mutual introduction. Participants were asked to rate their subjective hunger feeling every 30 min after oral administration of 8 mL/kg carbohydrate nutrient solution that contained 10% maltodextrin and 2.5% sucrose. Consecutively, the gastric residual fluid was measured by magnetic resonance imagining (MRI). The Spearman’s correlation coefficient, the ROC curves and the stepwise regression were used to analyze the predictive value of NRS for the gastric emptying process.ResultsThe cohort consisted of 29 healthy volunteers enrolled in this study. The area under ROC curves estimated by the NRS score for the gastric residual volume of 2 mL/kg, 1 mL/kg, and 0.5 mL/kg were AUC2.0 = 0.78, AUC1.0 = 0.76, and AUC0.5 = 0.72, respectively. The correlation coefficient between the NRS score and the residual liquid in the stomach was −0.57 (P < 0.01). The correlation coefficient between the increase of the NRS score and the decrease of gastric liquid residual volume was 0.46 (P < 0.01). The standardized estimate of NRS score for the residual volume was −0.18 (P < 0.01) and the standardized estimate of fasting time was −0.73 (P < 0.01).ConclusionsThe subjective hunger NRS score can not accurately predict the gastric residual volume, but it can provide a reference for clinicians to judge the gastric emptying process and it should be used as a second check after oral intake of clear fluids before surgery according to the new fasting protocol.
Highlights
Surgical patients are asked to fast for a sufficient duration to ensure that the amount of residual liquid in the stomach is within the safe range, thereby reducing the risk of gastric reflux perioperatively
Our study focused on the predictive value of subjective hunger numerical rating scale (NRS) score for the gastric residual volume and the gastric emptying process in adults, who can clearly express their feeling of hunger, especially after the enhanced recovery after surgery (ERAS) and new fasting protocol have been applied
Our results showed that the NRS scores of T30 and T60 were significantly lower than the Tb point and increased gradually after oral administration of the nutrient solution, which was consistent with the trend of gastric emptying (Table 1)
Summary
Surgical patients are asked to fast for a sufficient duration to ensure that the amount of residual liquid in the stomach is within the safe range, thereby reducing the risk of gastric reflux perioperatively. The authors hypothesized that subjective hunger numerical rating scale (NRS) score could help assess the process of gastric emptying and determine the amount of fluid remaining in the stomach. The recently amended guidelines invariably recommend shortening of the preoperative fasting duration This is because gastric residual volume is considered as the most important predictor of the risk of gastric reflux episodes during anesthesia, while preoperative fasting is speculated as the most controllable parameter to ensure an empty stomach to prevent perioperative gastric reflux and inspiration pneumonia during anesthesia induction [5]. Our study focused on the predictive value of subjective hunger numerical rating scale (NRS) score for the gastric residual volume and the gastric emptying process in adults, who can clearly express their feeling of hunger, especially after the ERAS and new fasting protocol have been applied. Our specific hypothesis was that subjective hunger NRS score would help the clinicians in a preliminarily finding on the gastric emptying process and predicting the gastric residual volume
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
