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→Neuraxial Labor Analgesia and Gastric Emptying
| [https://dx.doi.org/10.1097/EJA.0000000000001514 Weiniger et al Eur J of Anaes 2022] || 80 non-fasted pregnant women, age 18+, GA 37+ weeks, singleton, cephalad, dilated <= 5 cm, 63 had empty stomachs and 17 had full stomachs at baseline || Double-blind single center RCT with women randomized to low-dose (50) or high-dose (100) epidural fentanyl. || Stomach antrum cross-sectional area (CSA) was measured with gastric US before and 2 hrs after fentanyl administration || No differences between low-dose and high-dose fentanyl groups.
| [https://dx.doi.org/10.1097/EJA.0000000000001514 Weiniger et al Eur J of Anaes 2022] || 80 non-fasted pregnant women, age 18+, GA 37+ weeks, singleton, cephalad, dilated <= 5 cm, 63 had empty stomachs and 17 had full stomachs at baseline || Double-blind single center RCT with women randomized to low-dose (50) or high-dose (100) epidural fentanyl. || Stomach antrum cross-sectional area (CSA) was measured with gastric US before and 2 hrs after fentanyl administration || No differences between low-dose and high-dose fentanyl groups.
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| [https://dx.doi.org/10.1097/ALN.0000000000004133 Chassard et al Anesthesiology 2022] || 40 women || Prospective cohort study of 10 parturiants. Each had gastric ultrasound (gUS) to verify empty stomach prior to ingestion of 125 g of yogurt within 5 min. For the epidural group, the meal was consumed within one hour of epidural placement. Serial gUS was performed at 15, 60, 90, and 120 minutes thereafter and fraction of gastric emptying was calculated as [Area_Antral_90 / Area_Antral_15 - 1]*100. || 10 pregnant women at term, 10 non-pregnant women, and 10 parturiants with no labor epidural. || Gastric emptying fraction (higher is better) was 52% (non-pregnant), 45% (pregnant), 7% (parturiants w/o epidural), and 31% (parturiants w/ epidural). Parturiants had delayed gastric emptying compared to non-parturiants, and epidural analgesia actually sped up gastric emptying.
| [https://dx.doi.org/10.1097/ALN.0000000000004133 Chassard et al Anes 2022] || 40 women || Prospective cohort study. Gastric ultrasound (gUS) was used to verify an empty stomach, then participants ate 125 g of yogurt within 5 min. For the epidural group, the meal was consumed within one hour of epidural placement. || 10 parturients with labor epidural were compared with 10 pregnant women at term, 10 non-pregnant women, and 10 parturiants with no labor epidural. Serial gUS was performed at 15, 60, 90, and 120 minutes after a light meal and fraction of gastric emptying was calculated as [Area_Antral_90 / Area_Antral_15 - 1]*100. || Gastric emptying fraction (higher is better) was 52% (non-pregnant), 45% (pregnant), 7% (parturiants w/o epidural), and 31% (parturiants w/ epidural). Parturiants had delayed gastric emptying compared to non-parturiants, and epidural analgesia actually sped up gastric emptying.
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| [https://dx.doi.org/10.1093/bja/aet435 Bonnet et al BJA 2014] ||
| [https://dx.doi.org/10.1093/bja/aet435 Bonnet et al BJA 2014] ||