Scholarlink

Background <p>Standard preoperative fasting guidelines are widely used to reduce the risk of pulmonary aspiration; however, their reliability in high-risk populations remains uncertain. Diabetes mellitus (DM) is associated with delayed gastric emptying, and neurological conditions such as intracranial tumors may further impair gastric motility. This study aimed to evaluate preoperative gastric antral dimensions and aspiration risk via gastric point-of-care ultrasound (POCUS) in diabetic patients undergoing elective intracranial tumor surgery.</p> Methods <p>This prospective, observational, single-center study included 48 adult patients scheduled for elective intracranial tumor surgery, comprising 24 patients with DM, and 24 non-DM patients. Preoperative gastric ultrasound was performed immediately before anesthesia induction by an anesthesiologist blinded to patient group allocation. The gastric antral cross-sectional area (CSA) and qualitative Perlas grade were assessed. The primary outcome was gastric antral CSA; secondary outcomes included estimated gastric residual volume (GRV) and the incidence of high-risk gastric ultrasound findings (Perlas Grade 2).</p> Results <p>Baseline demographic and perioperative characteristics were comparable between the groups. The median gastric antral CSA was significantly greater in the DM group than in the non-DM group (4.41 [3.73–5.53] vs. 3.80 [3.50–4.56] cm²; <i>p</i> = 0.021). The estimated GRV was numerically greater in the DM group but did not differ significantly between groups (<i>p</i> = 0.217). Although not statistically significant, Perlas Grade 2 findings were numerically more frequent in diabetic patients.</p> Conclusions <p>Diabetic patients who undergo elective intracranial tumor surgery exhibit increased gastric antral dimensions and numerically higher incidence of high-risk gastric ultrasound findings despite adherence to standard fasting guidelines. These results suggest that fasting duration alone may be insufficient to exclude aspiration risk in this population. Gastric POCUS may provide valuable individualized information to guide perioperative anesthetic management in diabetic neurosurgical patients.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Preoperative gastric ultrasound reveals increased aspiration risk in diabetic patients undergoing elective intracranial tumor surgery: a prospective observational study

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2026年4月18日

查看全文
  • Nihal Gökbulut Özaslan,
  • Gokhan Erdem

摘要

Background

Standard preoperative fasting guidelines are widely used to reduce the risk of pulmonary aspiration; however, their reliability in high-risk populations remains uncertain. Diabetes mellitus (DM) is associated with delayed gastric emptying, and neurological conditions such as intracranial tumors may further impair gastric motility. This study aimed to evaluate preoperative gastric antral dimensions and aspiration risk via gastric point-of-care ultrasound (POCUS) in diabetic patients undergoing elective intracranial tumor surgery.

Methods

This prospective, observational, single-center study included 48 adult patients scheduled for elective intracranial tumor surgery, comprising 24 patients with DM, and 24 non-DM patients. Preoperative gastric ultrasound was performed immediately before anesthesia induction by an anesthesiologist blinded to patient group allocation. The gastric antral cross-sectional area (CSA) and qualitative Perlas grade were assessed. The primary outcome was gastric antral CSA; secondary outcomes included estimated gastric residual volume (GRV) and the incidence of high-risk gastric ultrasound findings (Perlas Grade 2).

Results

Baseline demographic and perioperative characteristics were comparable between the groups. The median gastric antral CSA was significantly greater in the DM group than in the non-DM group (4.41 [3.73–5.53] vs. 3.80 [3.50–4.56] cm²; p = 0.021). The estimated GRV was numerically greater in the DM group but did not differ significantly between groups (p = 0.217). Although not statistically significant, Perlas Grade 2 findings were numerically more frequent in diabetic patients.

Conclusions

Diabetic patients who undergo elective intracranial tumor surgery exhibit increased gastric antral dimensions and numerically higher incidence of high-risk gastric ultrasound findings despite adherence to standard fasting guidelines. These results suggest that fasting duration alone may be insufficient to exclude aspiration risk in this population. Gastric POCUS may provide valuable individualized information to guide perioperative anesthetic management in diabetic neurosurgical patients.