• Shinji Oshima, Yoshitaka Aoki, Yohei Kawasaki, and Junichiro Yokoyama.
• Department of Anesthesiology, Hamamatsu Medical Center, Hamamatsu, Shizuoka, Japan. Electronic address: m1401514015@gmail.com.
• J Clin Anesth. 2018 Sep 1; 49: 7-11.

ObjectivePreoperative oral rehydration solutions (ORS) are frequently used in clinical practice in Japan, although their effect remains to be explained. The purpose of this study was to investigate the clinical outcomes associated with ORS usage.DesignSystematic review and meta-analysis.SettingSurgical departments at each hospital.ParticipantsA total of 546 patients with American Society of Anesthesiologists physical status classification I or II (non-pregnant adults only) reported in six articles.InterventionsPatients in the included studies had originally been randomly allocated to the ORS or control group.MeasurementsIncidence of aspiration and vomiting during induction of anesthesia, gastric fluid volume (absolute volume), gastric pH, stroke volume variation (SVV) during induction of anesthesia. Risk difference (RD) or mean difference (MD) with 95% confidence interval (CI) were calculated using a random effects model.Main ResultsThere was no aspiration or vomiting in either group [3 studies, 428 patients, RD 0 (95% CI -0.01 to 0.01), I2 = 0%]. ORS administration caused no significant difference in gastric volume [4 studies, 486 participants, MD -1.12 ml (95% CI -5.61 to 3.36), I2 = 62%] or gastric pH [4 studies, 486 participants, MD -0.03. (95% CI -0.37 to 0.31), I2 = 0%] compared with the control group. In contrast, ORS resulted in a significant reduction in SVV during the anesthesia induction period [3 studies, 118 participants, MD -3.02 (95% CI -5.44 to -0.59), I2 = 65%].ConclusionsOur systematic review indicates that oral rehydration therapy does not increase the risk of aspiration or vomiting. In contrast, it may help stabilize circulatory dynamics during anesthesia induction.Copyright © 2018 Elsevier Inc. All rights reserved.

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