Comparison of Gastric Residual Volume and pH between
Single and Split-Dose Bowel Preparation in Patients
Undergoing Esophago-Gastro-Duodenoscopy and
Colonoscopy: A Randomized Controlled Trial
Araya Ongiem BNS¹, Uayporn Kaosombatwattana MD², Pukkaporn Katseesung BNS³, Suthipol Udompunthurak MSc⁴,
Phongthara Vichitvejpaisal MD, PhD¹
Affiliation : ¹ Department of Anesthesiology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand ² Division of Gastroenterology, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand ³ Nursing Division, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand ⁴ Office of Research Promotion, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
Background: Colonoscopy is an effective surveillance for the diagnosis and screening of colorectal cancer (CRC). Prior to the procedure, people
would take laxatives for a good visualization of bowel texture. Although a split-dose bowel preparation has become popular, many anesthesiologists
are concerned about pulmonary aspiration.
Objective: To study the gastric residual volume and pH in patients taking split-dose bowel preparation as compared to those having laxatives on the day before the procedure.
Materials and Methods: One hundred patients were randomized equally into two groups, as A for a single-dose, and B for a split-dose regimen. All patients underwent endoscopy under standard anesthetic care. The total gastric residual volume was suctioned, and pH was measured through the endoscope. The surgical team was unaware of the study protocol. The quality of bowel cleansing was assessed by the endoscopist using the Boston Bowel Preparation Scale (BBPS).
Results: The bowel cleansing, the latency period, the endoscopist and patients’ satisfaction of single-and split-dose group were 7.06±1.4 and 8.14±1.1, 13.3±1.1 and 4.2±0.4 hours, 62.0% and 94.0%, and 90.0% and 74.0%, respectively. They all showed statistically significant differences between the two groups (p<0.05).
Conclusion: The gastric residual volume and pH were not different between the split and single-dose preparations. Therefore, it might not increase the risk of aspiration pneumonitis. However, the split-dose technique was more effective in colon cleansing, patients’ tolerability, acceptability, and compliance than the preparations administered entirely the day or evening before the surgical procedure.
Received 15 March 2021 | Revised 31 August 2021 | Accepted 2 September 2021
doi.org/10.35755/jmedassocthai.2021.10.12688
Keywords :
Gastro-colonoscopy; Single-dose bowel preparation; Split-dose bowel preparation; Gastric residual volume; Anesthesia
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