كارآزمايي باليني تأثير دريافت مايعات خوراكي يك ساعت قبل از عمل جراحي سزارين انتخابي بر بروز رگورژيتاسيون

The Clinical Trial on Oral Fluid Intake Effects an Hour before Cesarean on Regurgitation Incidence.

Background: The fear of aspiration of gastric contents and its life threatening consequences in patients have caused many medical practitioners to rigidly follow conservative order for clear fluids / liquids and solids frm midnight to the surgery time. This policy has been pursued more severely in case of pregnant women, leading the physicians to follow "nil per os policy".The scientific base of such a decision in parturient had been the urgent probable necessity for cesarean section and no confidence of safety of taking fluids sooner than two hours before the induction of anesthesia. Objective: The purpose of this study was to determine and compare the incidence of regurgitation in two groups of pregnant women during general anesthesia for cesarean section with standard fasting policy and taking clear fluid an hour preceding the induction of anesthesia. Materials and Methods: This clinical trial study was carried out for 21 months in traing Niknafs medical center of Rafsanjan. The population consisted of the whole pregnant women who were scheduled for elective cesarean section. Women were excluded if they had any risk factors for regurgitation. All women fasted from midnight and were randomly assigned to one of the two groups. One-third was assigned to the fasting group and two-third participated in the fluid group. Those in the fluid group were given 150 ml carbohydrate 10% clear liquid about an hour preceding of induction anesthesia. The occurance of regurgitation was assessed by inserting the turnsole paper. Finally, the data of 411 cases were collected and analyzed. Results And Conclusion: There was one case of regurgitation in the fasting group and one case of regurgitation in the fluid group. There was no evidence to suggest that drinking clear fluid about one hour preceding cesarean section resulted in an increased risk of regurgitation. Moreover, There was no case of aspiration. Considering the scarcity of aspiration syndrome in our hospitals compared to European countries and lack of evidence sugst that a shortened fluid fast leads to the increased risk of aspiration and regurgitation, it seems appropriate to follow more flexible fasting policies for surgeries of pregnant women, especially among parturient.