• Birgit Larsen, Lars P Larsen, Kim Sivesgaard, and Svend Juul.
• From the Department of Day Surgery, Aarhus University Hospital (BL); Department of Radiology, Aarhus University Hospital (LPL, KS); and Department of Public Health - Department of Epidemiology, Aarhus University, Aarhus, Denmark (SJ).
• Eur J Anaesthesiol. 2016 Jun 1; 33 (6): 457-62.

BackgroundIn current preoperative fasting guidelines, coffee with milk is still regarded by many as solid food. Evidence on the consequences for gastric volume of adding milk to coffee 2 h before anaesthesia is still weak.ObjectivesThe aim of this study was to compare the gastric volume by MRI in healthy volunteers after drinking coffee with and without added milk.DesignA randomised crossover trial where all participants were exposed to three coffee and milk mixtures performed as a noninferiority study with a predefined noninferiority limit of 12 ml.SettingDepartment of Day Surgery and Department of Radiology, Aarhus University Hospital, Aarhus, Denmark. The study was conducted between August 2013 and February 2014.ParticipantsTotal 32 healthy volunteers, aged 18 to 71 years.InterventionsThe participants fasted for 6 h for solid food, and 2 h before the MRI examination of gastric volume, each participant ingested one of three coffee mixtures: 175 ml coffee, including either 0 or 20 or 50% full fat milk. Each participant was studied by MRI three times separated by a minimum time interval of 2 days. The order of coffee mixture ingested was determined by random allocation.Main Outcome MeasureGastric volume as measured by MRI.ResultsThe mean gastric volume for black coffee was 27.8 ml, for coffee with 20% milk 17.9 ml and for coffee with 50% milk 20.6 ml. Compared to black coffee, the gastric volume for 20% milk was significantly decreased with a difference of -10.0 ml (95% confidence interval, -18.2, -1.8), and for 50% milk it was insignificantly decreased, -7.2 ml (95% confidence interval, -17.4, +2.9). The upper confidence interval for the difference in gastric volume between the 'no milk added' group and each 'milk added' group did not reach the noninferiority limit of 12 ml.ConclusionThe study provides evidence that adding up to 50% full fat milk to coffee leads to no or only a minimal increase of the gastric volume 2 h later. The results support a liberalisation of policy on the addition of milk to hot drinks before planned anaesthesia.Trial Registrationwww.Clinicaltrials.gov identifier: NCT02361632.

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