Ultrasonographic assessment of metoclopramide effect on gastric volume in parturients females undergoing Caesarean section: a randomized double blind study

BACKGROUND: The prokinetic effect of metoclopramide promotes gastric emptying and decreases stomach capacity. The aim of the present study was to assess the efficacy of metoclopramide in reducing gastric contents and volume using gastric point-of-care ultrasonography (PoCUS) in parturients females prepared for elective Cesarean section under general anesthesia.METHODS: A total of 111 parturient females were randomly allocated to one of two groups. The intervention group (Group M; N.=56) received 10 mg metoclopramide diluted in 10 mL 0.9% normal saline. The control group (Group C; N.=55): received 10 mL 0.9% normal saline. The cross-sectional area and volume of stomach contents were measured using ultrasound before and one hour after the administration of metoclopramide or saline.RESULTS: Statistically significant differences in mean antral cross-sectional area and gastric volume were observed between the two groups (P<0.001). Group M had significantly lower rates of nausea and vomiting compared to the control group. CONCLUSIONS: Metoclopramide decreases gastric volume, reduces postoperative nausea and vomiting, and may lower the risk of aspiration when used as premedication before obstetric surgery. Preoperative gastric PoCUS has utility in objectively assessing stomach volume and contents.