Perioperative fasting and feeding in adults, obstetric, paediatric and bariatric population: Practice Guidelines from the Indian Society of Anaesthesiologists

Dongare, Pradeep A; Bhaskar, S Bala; Harsoor, SS; Garg, Rakesh; Kannan, Sudheesh; Umesh, Goneppanavar; Ali, Zulfiqar; Ramachandran, Gurumurthy; Sood, Jayashree; Kalaivani, Mani; Bhatia, Pradeep; P, Rohatgi; Das, Rekha; Ghosh, Santu; Mahankali, Subramanyam; Bajwa, Sukhminder Jit Singh; Gupta, Sunanda; Pandya, Sunil K; Keshavan, Venkatesh H; Joshi, Meera; Malhotra, Naveen

doi:10.4103/ija.ija_735_20

Cited by 30 publications

(27 citation statements)

References 333 publications

(511 reference statements)

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“…[ 6 7 11 13 ] Recently published fasting guidelines by the Indian Society of Anaesthesiologists suggest that gastric ultrasound is a weak recommendation as a bedside tool for qualitative and quantitative assessment of gastric contents in the preoperative period. [ 2 ] Arzola's study concluded that 33 ultrasound examinations were adequate to achieve 95% competence; this was based on qualitative assessment and did not involve actual measurement of volumes. [ 7 16 ] In another study, anaesthesiologists performed USG-based GRV assessments after training under the supervision of a radiologist for 20 cases; they did not do a head-to-head comparison of agreement between measurements by the radiologist and anaesthesiologist.…”

Section: Discussionmentioning

confidence: 99%

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Ultrasound-guided assessment of gastric residual volume in patients receiving three types of clear fluids: A randomised blinded study

Doctor¹,

Chandan²,

Shetty³

et al. 2021

Indian J Anaesth

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Background and Aims: Ultrasonography (USG) is used to evaluate gastric residual volume (GRV); however, this technique may have inter-assessor variability. This study aimed to measure GRV in three groups of fasted patients 2 h after they received 200 mL of water, clear apple juice or apple-flavoured oral rehydration solution (ORS) and to determine inter-assessor reliability of USG-guided GRV measurement. Methods: We randomised 90 adult patients planned for elective cancer surgery, with no risk factors for delayed gastric emptying, to receive 200 mL of water, clear apple juice or apple-flavoured ORS after overnight fasting. Two hours later, two blinded assessors (a trained anaesthesiologist and a radiologist) independently determined USG-guided GRV. The primary outcome was GRV measured by the radiologist. The secondary outcome was inter-assessor correlation and agreement in GRV measurements. Results: There was no statistically significant difference in median GRV between groups (apple-flavoured ORS 74.8 mL, apple juice 63.7 mL, and water 62.1 mL, P = 0.11). We found poor correlation between measurements of radiologist and anaesthesiologist (Intra-class correlation coefficient 0.3, 95% confidence intervals 0.09 to 0.48, P value 0.002). The average (mean) bias was 5.4 mL (standard deviation 42.3 mL) and the 95% limits of agreement were -79.2 ml to +90 ml. Conclusion: Patients receiving 200 mL of water, clear apple juice or apple-flavoured ORS had comparable GRV after 2 h. There was poor correlation and agreement between GRV measurements of different assessors, indicating that more training may be required for anaesthesiologists to attain proficiency in the quantitative assessment of GRV.

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Section: Discussionmentioning

confidence: 99%

“…This is in order to minimise peri-operative aspiration risk while avoiding prolonged fasting and dehydration. [ 1 2 ]…”

Section: Introductionmentioning

confidence: 99%

Ultrasound-guided assessment of gastric residual volume in patients receiving three types of clear fluids: A randomised blinded study

Doctor¹,

Chandan²,

Shetty³

et al. 2021

Indian J Anaesth

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show abstract

“…This cannot be better exemplified than the formulation of the 'ISA Fasting and Feeding Guidelines' which are being published in this issue of the Indian Journal of Anaesthesia (IJA). [ 2 ] All the authors have collectively worked hard in formulating plans and policies, collecting the evidence, analysing the data and details as well as discussing numerous times about each and every minute detail of these guidelines so as to arrive at an appropriate evidence- based document. These guidelines have comprehensively covered everything based on the strength of evidence for each and every frequent query related to fasting and feeding instructions before surgery in various subsets of population.…”

Section: Teammentioning

confidence: 99%

“…These guidelines have comprehensively covered everything based on the strength of evidence for each and every frequent query related to fasting and feeding instructions before surgery in various subsets of population. [ 2 ]…”

Section: Teammentioning

confidence: 99%

The ten essential “T's” imparting impetus to research in anaesthesiology

Bajwa

Kumar

Mehdiratta³

2020

Indian J Anaesth

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“…I read with great interest “Perioperative fasting and feeding in adults, obstetric, paediatric and bariatric population: Practice Guidelines from the Indian Society of Anaesthesiologists” by Dr Dongare et al . [ 1 ] I would like to congratulate the authors for such a comprehensive analysis of a very important and relevant topic.…”

mentioning

confidence: 99%

Perioperative Fasting Guidelines- No oral intake upto 8 hours after caeserean section?

Wagh

2020

Indian J Anaesth

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Perioperative fasting and feeding in adults, obstetric, paediatric and bariatric population: Practice Guidelines from the Indian Society of Anaesthesiologists

Cited by 30 publications

References 333 publications

Ultrasound-guided assessment of gastric residual volume in patients receiving three types of clear fluids: A randomised blinded study

Ultrasound-guided assessment of gastric residual volume in patients receiving three types of clear fluids: A randomised blinded study

The ten essential “T's” imparting impetus to research in anaesthesiology

Perioperative Fasting Guidelines- No oral intake upto 8 hours after caeserean section?

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