The efficacy of preoperative fasting is reduced in the presence of any factor which delays gastric emptying. We examined the association between anxiety and gastric emptying in adult patients undergoing elective surgery. Immediately before operation, 21 patients completed both a Spielberger state trait inventory (used to quantify current anxiety state (STAIs) and anxiety predisposition (STAIt)), and the Amsterdam preoperative anxiety and information scale (used to quantify anxiety and need for information). Gastric emptying was measured using the paracetamol absorption technique. Four to 10 weeks later, gastric emptying and STAI were measured again. Patients were more anxious before than after operation (STAIs = mean 35.4 (SD 10.9) and 25 (4.1), respectively; P = 0.0004). Neither anxiety state (P = 0.40) nor measures of anxiety relative to anxiety predisposition (P = 0.86) influenced gastric emptying (as measured by area under the paracetamol absorption-time curve). This contrasts with previous findings that anxiety in patients with low anxiety predisposition scores delays gastric emptying.
Purpose: To evaluate the efficacy of 20 mg cisapride p0 in reducing residual gastric volume and pH in adult ambulatory surgical patients. Methods: Using a prospective randomised double-blind controlled design, we administered either 20 mg cisapdde p0 or placebo preoperatively to 64 ASA 1-2 ambulatory surgical patients. Following induction of anesthesia we measured volume and pH of residual gastric contents, using blind aspiration through an orogastric tube. Parametric data were analysed using unpaired, one tail Students' t test. Non-parametric data were analysed using Fishers Exact test and Chi square analysis. Statistical significance was accepted at the probability level of < 0.05. Results: Residual gastric volumes were similar in the two groups (19.5-23.8, 23.9 • 24.4 ml), in the cisapride and placebo groups respectively, P=0.24). Data shown are mean (• SD). The proportions of patients with a residual gastric volume exceeding 0.4 ml-kg-I were similar in the two groups (4 of 28, and 8 of 23 patients in the cisapride and placebo groups respectively, P=0.09). The pH of the residual gastric contents were similar in the cisapride and placebo groups (1.6 • 0.5, 1.4 _ 0.5, respectively, P=0.26). The proportions of patients with pH < 2.5 was also similar in the cisapride and placebo groups (21 of 25, and 20 of 21 patients respectively, P=0.2). Conclusions: Preoperative administration of 20 mg cisapride po to patients scheduled for outpatient surgery does not alter either the volume or the pH of gastric contents. Its use in this setting is of no apparent clinical benefit.
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