Aspiration is the leading contributor of anaesthetic-related morbidity and mortality, of which inaccurate risk assessment is often the root cause. Fasting patients to ensure they have an empty stomach prior to general anaesthesia is a mainstay of anaesthetic management. Emergency surgery represents a significant risk factor, with up to 56 per cent having a "full" stomach on ultrasound assessment.
This is particularly relevant in patients with acute intra-abdominal pathology, who can have delayed gastric emptying with large stomach volumes. The aim of this study is to define the relationship between hunger and fasting as assessed by gastric ultrasound in patients with acute intra-abdominal pathology. The investigators hypothesise that hunger is a reliable indicator of an empty stomach, and the study aims to validate the use of these symptoms to guide anaesthetic management. Gastric ultrasound is a point-of-care assessment tool to that can be used to quantify aspiration risk in patients undergoing general anaesthesia. It is non-invasive, fast and easy to perform procedure which has been well validated.
The project will allow anaesthetists to make better decisions when managing patients, potentially reducing the risk of aspiration and improving the safety of anaesthesia. If a strong association between hunger and an empty stomach on ultrasound is found, this then validates the use of hunger as an indication of fasting. This approach will have great utility in low-resource settings where ultrasound may not be available.
Dr Fraser Morton, Dr Michael Busser, Royal Brisbane and Women's Hospital, Queensland
The project was awarded $A17,808 funding through the ANZCA research grants program for 2023.