• Jing Wang, Xuan Yu, Ying Wang, JieLei Xu, Zhao Wang, and Yi Zhang.
• Department of Anesthesiology, the Second Affiliated Hospital of Zunyi Medical University, Intersection of Xinglong Avenue and Xinpu Avenue, Zunyi, 563000, Zunyi, China.
• BMC Anesthesiol. 2024 Sep 6; 24 (1): 317317.

BackgroundPerioperative reflux aspiration presents a grave concern during sedation or general anesthesia, particularly when solid gastric contents prompt acute upper respiratory obstruction, potentially resulting in fatal consequences for patients. Currently, there are limited means for promptly assessing solid gastric contents in clinical settings. Therefore, this study examined the efficacy of ultrasound assessment for solid gastric contents, offering a rapid and non-invasive approach for early detection and decision-making regarding interventions.MethodsThe study included 400 patients scheduled for upper endoscopy procedures, which encompassed both gastroscope and gastroscope combined colonoscopy examinations with sedation. Ultrasound scanning of the antrum was performed while patients were positioned semi-sitting or in the right lateral decubitus (RLD) posture. The evaluation of solid gastric contents relied on direct visual observation during endoscopy. Gastric volume measurement occurred subsequent to endoscopic suction of gastric contents. Receiver operating characteristic curves were utilized to assess the effectiveness of ultrasonography in discerning solid contents.ResultSeven patients undergoing gastroscope with sedation were found to have solid gastric contents. The sensitivity, specificity, positive predictive value, and negative predictive value of the ultrasound qualitative evaluation of solid contents were 85.7%, 99%, 60%, and 99.7%, respectively.ConclusionSolid stomach contents can be evaluated qualitatively with reasonable accuracy using ultrasonography. Additionally, in patients undergoing upper endoscopy and assessed to have solid gastric contents with ultrasound, administration of mild sedation is recommended.Trial Registrationwww.chictr.org.cn (ChiCTR2100048994); registered 19/07/2021.© 2024. The Author(s).

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