Korean J Anesthesiol.  2006 Jun;50(6):S28-S30. 10.4097/kjae.2006.50.6.S28.

The Effects of Preoperative Vaginal Misoprostol on Gastric Contents

• Hong JY
• Kim MJ

• KMID: 1862260
• DOI: http://doi.org/10.4097/kjae.2006.50.6.S28

Abstract

BACKGROUND: The aim of this study was to evaluate the effect of vaginal misoprostol for operative hysteroscopy on preoperative gastric contents and the risk of acid aspiration pneumonitis.
METHODS
Sixty-five patients undergoing operative hysteroscopy who received prophylactic vaginal misoprostol 200 microgram were assigned to the misoprostol group, and sixty-five gynecologic patients without premedication were assigned to the control group. After preoxygenation, a 14-F multiorifice nasogastric tube was inserted for direct aspiration under target-controlled propofol sedation.
RESULTS
The mean pH value of gastric fluid was significantly higher in the misoprostol group (2.7 +/- 1.0) than the control group (1.9 +/- 0.7). The mean aspirated volume was (ml) 15.3 +/- 7.4 in the misoprostol group and 16.8 +/- 6.9 in the control group (P > 0.05). There were significantly less patients at high-risk (gastric fluid volumes > 25 ml and pH < 2.5) in the misoprostol group (8/65, 12.3%) than in the control group (18/65, 27.7%). Prophylactic vaginal misoprostol increases the preoperative gastric pH and reduces the number of at high-risk of acid aspiration pneumonitis.
CONCLUSIONS
Therefore, vaginal misoprostol for outpatient hysteroscopy may have preventive effect on the acid aspiration pneumonitis.

Keyword

aspiration pneumonitis; gastric content; outpatient surgery; prostaglandins E

MeSH Terms

Ambulatory Surgical Procedures
Humans
Hydrogen-Ion Concentration
Hysteroscopy
Misoprostol*
Outpatients
Pneumonia
Premedication
Propofol
Prostaglandins E
Misoprostol
Propofol
Prostaglandins E