A study on the application value of bedside gastric antrum ultrasound in assessing gastric contents in patients undergoing outpatient painless digestive endoscopy

ZHANG Xu; LIANG Suzhen; ZHOU Zhihu; HUANG Liqiao; LONG Yufang; SHI Min; YANG Tiande

doi:10.3969/j.issn.1674-3806.2024.04.05

Abstract：Objective To study the application value of bedside gastric antrum ultrasound in assessing the gas-tric contents and the risk of reflux and aspiration in patients undergoing outpatient painless digestive endoscopy.Methods A total of 616 patients undergoing elective painless digestive endoscopy for diagnosis and treatment in the Second Affili-ated Hospital of Guilin Medical University from November 2021 to March 2022 were selected,and bedside gastric antrum ultrasound was performed on the patients 10 minutes before painless digestive endoscopy.Ultrasound examination results including the nature of gastric contents,Perlas gastric antrum grading,right lateral decubitus gastric antrum cross-sectional area(RLD CSA)and predicted gastric volume,and changes in anesthesia protocols were observed and recorded.The actual gastric volume aspirated during gastroscopy and the full stomach detected by gastroscopy were recorded.The cor-relations of RLD CSA and predicted gastric volume with actual gastric volume were assessed by using Pearson correlation analysis.The predictive value of RLD CSA for full stomach was assessed by receiver operating characteristic(ROC)curve analysis.Results Nineteen patients did not obtain typical ultrasound images of the gastric antrum,and 597 patients were included in statistical analysis.The ultrasound exmination time for all the patients was(2.9±0.9)minutes.Forty-two patients(7.0％)were diagnosed by ultrasound as having a full stomach.The anesthesia regimens of the patients diagnosed with full stomach by ultrasound were changed,among whom 4 patients were given delayed anesthesia and 38 patients underwent ordinary gastroscopy.Under gastroscopy,31 patients were found to have actual full stomach,of whom 28 patients were found to have liquid full stomach and 3 patients were found to have solid full stomach.No reflux and aspiration occurred in all the patients.Pearson correlation analysis showed that RLD CSA and predicted gastric volume were posi-tively correlated with actual gastric volume(P＜0.05).The results of ROC curve analysis showed that RLD CSA had the application value of predicting full stomach[the area under the curve(AUC)(95％CI)=0.926(0.864-0.987),P＜0.001],and the optimal cut-off value was 7.87 cm2,and the corresponding sensitivity and specificity were 96.4％and 78.6％,respectively.Conclusion Bedside gastric antrum ultrasound can be used to assess the gastric contents and the risk of reflux and aspiration in patients undergoing outpatient painless digestive endoscopy.Bedside gastric antrum ultrasound is feasible and accurate,and has good clinical application value in assessing the gastric contents and the risk of reflux and aspiration in patients undergoing outpatient painless digestive endoscopy.