Endoscopic assessment of gastric emptying in older adults after preoperative administration of 5% glucose solution: a randomized controlled study.

Abstract

Background: Delayed gastric emptying of liquids may heighten the risk of aspiration reflux in elderly individuals. To investigate the gastric emptying of an oral supplement containing 5% dextrose solutions before sedation for gastroscopy.

Patients and methods: A total of 100 elderly patients who were scheduled for elective gastroscopy were randomly assigned to two groups: the NPO(nil per os ) group and the dextrose solution ingestion group, which ingested a 5% dextrose solution (5 ml/kg) two hours before the procedure. The primary outcome measure was the gastric volume (GV) suctioned and measured during the gastroscopic examination. Secondary outcome measures included GV per weight (GV/kg), post-discharge blood glucose levels, patient discomfort assessed using the Visual Analog Scale (VAS), clarity of gastric mucosal visualization during gastroscopy, and the incidence of adverse events. Additionally, linear regression analysis was employed to identify factors influencing gastric volume.

Results: There were no significant differences in gastric volume (GV) (P=0.258) and GV per weight (GV/W) (P=0.137) between the NPO group and the dextrose solution group. However,the NPO group had higher discomfort scores on the Visual Analog Scale compared to the dextrose solution group, with a statistically significant difference(P<0.001). The clarity of gastric mucosal visualization during gastroscopy was also significantly different between the two groups(P=0.038). Blood glucose levels and the incidence of adverse events showed no significant differences between the two groups.Multivariate linear regression analysis revealed that younger age and higher functional dyspepsia symptom diary (FDSD) scores were associated with larger gastric volume, with the regression equation being: GV = 79.922 - 1.186 $\times$ age + 0.556 $\times$ FDSD.

Conclusion: In elderly patients, drinking 5 ml/kg of a 5 % glucose solution two hours prior to gastroscopy does not significantly increase gastric volume compared to midnight fasting.

Trial registration: ChiCTR2100047031 (date of registration: 7 June 2021).