COMPARISON OF FASTING GASTRIC VOLUME USING ULTRASOUND IN DIABETIC AND NON-DIABETIC PATIENTS UNDERGOING ELECTIVE SURGERY: AN OBSERVATIONAL STUDY

Abstract

Background: Delayed gastric emptying is a common complication in diabetic patients due to autonomic neuropathy, increasing the risk of pulmonary aspiration during anesthesia. This study evaluates fasting gastric volume (GV) in diabetic versus non-diabetic patients using point-of-care ultrasound (POCUS).

Objectives: To compare gastric antrum cross-sectional area (CSA) and fasting gastric volume in diabetic and non-diabetic individuals scheduled for elective surgery. Secondary objectives included analyzing the relationship between gastric volume and clinical parameters such as age, BMI, and duration of diabetes.

Methods: A comparative observational study was conducted involving 120 participants equally divided into two groups—60 diabetics (Group D) and 60 non-diabetics (Group C). Gastric antrum CSA and GV were measured using a curvilinear ultrasound probe in both supine and right lateral decubitus (RLD) positions. Grading of the antrum was performed using the Perlas 3-point grading system.

Results: Diabetic patients exhibited significantly larger antral CSA and gastric volumes. Group D had a mean GV of 62.51 ± 40.74 ml, whereas Group C recorded 48.50 ± 31.15 ml (p = 0.036). Ultrasound grading revealed higher proportions of Grade 2 content in diabetics than in non-diabetics. Antral diameters and CSA differences were statistically significant in both positions.

Conclusion: The observed increase in fasting gastric volume among diabetic individuals highlights the value of preoperative gastric ultrasound in identifying patients at greater aspiration risk. Routine use of POCUS in pre-anesthetic assessment could personalize perioperative care in diabetics.