Abstract
The effect on gastric pH and volume of 0, 6 and 10 ml · kg−1, of apple juice given 2.5 hours before surgery to children aged five to ten years was investigated in this prospective, randomized, single-blind study. Gastric contents were aspirated after induction of anaesthesia, and the volume measured. The pH of the gastric aspirate was then assessed using pH paper. Neither gastric volume nor pH immediately following the induction of general anaesthesia were significantly different among the three groups. Gastric volumes after 0, 6 and 10 ml · kg−1, of juice averaged (mean ±SD) 0.45 ±0.31, 0.66 ±0.79 and 0.71 ±0.76 ml · kg−1, respectively; gastric pH averaged 1.7 ±0.6, 1.7 ±0.6 and 1.8 ±0.8, respectively. On the basis of questions asked immediately before induction of anaesthiesia, patients who drank 6 ml · kg−1 of apple juice had decreased thirst and were less irritable and upset before anaesthesia than those who had not (P < 0.05). It is concluded that drinking large volumes of clear apple juice 2.5 hours before scheduled surgery does not have a measurable effect on gastric volume and pH and may offer benefits such as improved patient comfort.
Résumé
L’effet sur le volume et le pH gastrique de 0,6 et 10 ml · kg−1 de jus de pomme donné 2.5 heures avant la chirurgie aux enfants âgés de cinq à dix ans a été investigué dans cette étude prospective randomisée et a simple insu. Le contenu gastrique fut aspiré après induction de l’anesthésie et le volume mesuré. Le pH du sue gastrique aspiré a par la suite été évalué par un papier à pH. Ni le volume gastrique ni son pH n’était significativement différent pour les trois groupes après l’induction de l’anesthesie générale. Le volume gastrique après 0,6 et 10 ml · kg−1 de jus de pomme était en moyenne (moyenne ±SD) respectivement 0,45 ±0,31, 0,66 ±0,79 et 0,71 ±0,76 ml · kg−1, en moyenne le pH gastrique était de 1,7 ±0,6, 1,7 ±0,6 et 1,8 ±0,8. Pour les avoir questionné immédiatement avant l’induction de l’anesthésie les patients ayant bu 6 ml · kg−1 de jus de pomme avaient moins soif et étaient moins irritables avant l’anesthésie que ceux qui n’en ont pas eu (P < 0.05). On conclut que l’ingestion dun large volume de jus de pomme 2.5 heures avant la chirurgie n’a pas d’effet mesurable sur le volume et le pH gastrique et peut offrir des bénéfices tel que l’amélioration du confort du patient.
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References
Hardy J-F. Large volume gastroesophageal reflux: a rationale for risk reduction in the perioperative period. Can J Anaesth 1988; 35: 162–73.
Splinter WM, Stewart JA, Muir JG. The effect of preoperative apple juice on gastric contents, thirst, and hunger in children. Can J Anaesth 1989; 36: 55–8.
Meakin G, Dingwall AE, Addison GM. Effects of fasting and oral premedication on the pH and volume of gastric aspirate in children. Br J Anaesth 1987; 59: 678–82.
van der Walt JH, Carter JA. The effect of different pre-operative feeding regimens on plasma glucose and gastric volume and pH in infancy. Anaesth Intensive Care 1986; 14: 352–9.
Sutherland AD, Maltby JR, Sale JP, Reid CRG. The effect of preoperative oral fluid and ranitidine on gastric fluid volume and pH. Can J Anaesth 1987; 34: 117–21.
Farrow-Gillespie A, Christensen S, Lerman J. Effect of the fasting interval on gastric pH and volume in children. Anesth Analg 1988; 67: S59.
Chaffe A. Which pH paper? Br J Anaesth 1987; 59: 1189–91.
Goudsouzian NG, Cote CJ, Liu LMP, Dedrick DF. The dose-response effects of oral cimetidine on gastric pH and volume in children. Anesthesiology 55; 1981: 533–6.
Nordgren B. The rate of secretion and electrolyte content of normal gastric juice. Acta Physiol Scand 1963; 58 Suppl 202.
Maltby JR, Reid CRG, Hutchinson A. Gastric fluid volume and pH in elective inpatients. Part II: coffee or orange juice with ranitidine. Can J Anaesth 1988; 35: 16–9.
Douglas WW. Autacoids. In: Goodman LS and Gilman A (Eds.). The Pharmacological Basis of Therapeutics. 7th ed. Toronto: Collier MacMillan Canada, Inc., 1985: 626–7.
Sleisenger MH, Fordtran JS. Gastrointestinal Disease. 3rd ed. Toronto: W. B. Saunders Company, 1983: 758.
Schuller LR, Feldman M, Richardson CT. Effect of sham feeding on gastric emptying. Gastroenterology 1980; 78: 1472–5.
Snyder JD. From pedialyte to popsicles: a look at oral rehydration therapy used in the United States and Canada. Am J Clin Nutr 1982; 35: 157–61.
Miller J, Kaufman G, Elasoff J et al. Search for resistances controlling canine gastric emptying of liquid meals. Am J Physiol 1981; 241: G403–15.
Hardy J-F, Plourde G, Lebrun M, Cote C, Dube S, Lepage Y. Determining gastric contents during general anaesthesia: evaluation of two methods. Can J Anaesth 1987; 34: 474–7.
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Splinter, W.M., Stewart, J.A. & Muir, J.G. Large volumes of apple juice preoperatively do not affect gastric pH and volume in children. Can J Anesth 37, 36–39 (1990). https://doi.org/10.1007/BF03007481
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DOI: https://doi.org/10.1007/BF03007481