The effect of oral hydration on the risk or aspiration and hemodynamic stability before the induction of anesthesia: A systematic review and meta-analysis.
OBJECTIVE
Preoperative 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.


DESIGN
Systematic review and meta-analysis.


SETTING
Surgical departments at each hospital.


PARTICIPANTS
A total of 546 patients with American Society of Anesthesiologists physical status classification I or II (non-pregnant adults only) reported in six articles.


INTERVENTIONS
Patients in the included studies had originally been randomly allocated to the ORS or control group.


MEASUREMENTS
Incidence 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 RESULTS
There 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%].


CONCLUSIONS
Our 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.
['Oshima|Shinji|S|', 'Aoki|Yoshitaka|Y|', 'Kawasaki|Yohei|Y|', 'Yokoyama|Junichiro|J|']
D000758:Anesthesia D005440:Fluid Therapy D006801:Humans D015994:Incidence D007432:Intraoperative Period D007564:Japan D011300:Preoperative Care D053120:Respiratory Aspiration D018570:Risk Assessment D013318:Stroke Volume D014839:Vomiting
Aspiration Systematic review Meta-analysis Vomiting Oral rehydration therapy