Semi-sitting position enhances gastric emptying of clear fluids in children: A randomized controlled trial

Abstract

Background: Enhancing gastric emptying would allow more liberal preoperative fasting guidelines in children. We evaluated the impact of semi-sitting position on gastric emptying of clear fluids compared to regular supine position in children. Methods: A randomized controlled trial included 30 fasting children aged between 4 and 16 years old. Gastric ultrasound was performed to evaluate the antral cross sectional area. Baseline measurements were obtained. After receiving oral apple juice (200 mL), participants were randomized into either supine group (n = 20) or semi-sitting group (n = 10). Serial ultrasound measurements of the antral cross sectional area were conducted every 30 min till complete evacuation of the stomach. The primary outcome was the number of children whom stomach returned to the baseline measurement (denoting complete gastric emptying) after 30 min. Other outcomes included antral cross sectional area and hunger satiety score. Results: After 30 min of fluid ingestion, 40% of the semi-sitting group showed complete gastric emptying; whilst, none of the children in the supine group showed complete gastric emptying after the same period (P = 0.008). Hunger satiety score increased in both groups after fluid ingestion; however, the duration of high hunger satiety score was shorter in the semi-sitting group. Conclusion: Semi-sitting position enhances gastric emptying of clear fluids in fasting children compared to supine position.