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Assessment of gastric emptying of maltodextrin, coffee with milk and orange juice during labour at term using point of care ultrasound: a non‐inferiority randomised clinical trial
Author(s) -
Nascimento A. C.,
Goveia C. S.,
Guimarães G. M. N.,
Filho R. P. L.,
Ladeira L. C. A.,
Silva H. B. G.
Publication year - 2019
Publication title -
anaesthesia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.839
H-Index - 117
eISSN - 1365-2044
pISSN - 0003-2409
DOI - 10.1111/anae.14671
Subject(s) - medicine , orange juice , gastric emptying , maltodextrin , meal , food science , orange (colour) , clearance , stomach , ultrasound , gastroenterology , zoology , urology , chemistry , organic chemistry , biology , spray drying , radiology
Summary Labouring women have been shown to have slower gastric emptying than non‐pregnant subjects, and this argument is sometimes used to recommend fasting guidelines such as nil‐by‐mouth during labour. We performed a parallel group, randomised non‐inferiority trial, comparing gastric emptying of 450 ml isocalorically‐adjusted maltodextrin, coffee with milk or pulp‐free orange juice, with 18 women in each group. The women were initially fasted for 2 h for clear fluids, 6 h for a light meal and 8 h for a high fat or high protein meal. We performed gastric ultrasound in the semirecumbent–right lateral decubitus position. Gastric antral area was measured at baseline and at 5 min, 30 min, 60 min, 90 min and 120 min. Gastric emptying of maltodextrin was significantly faster than coffee with milk (p < 0.001) and orange juice (p < 0.001). There was no statistically significant difference between pulp‐free orange juice and coffee with milk (p = 0.97). The estimated gastric residual volume was lower than baseline from 90 min after drinking maltodextrin. In labouring women, maltodextrin is cleared from the stomach faster than coffee with milk and orange juice. Gastric emptying depends on other factors besides the caloric load and volume of the drink.