Abstract:
Background: Diabetic patients undergoing elective surgery are at increased risk
of pulmonary aspiration due to gastroparesis, which leads to delayed gastric
emptying and increased gastric residual volume (GRV). Proton pump inhibitors
(PPIs) such as Dexlansoprazole have been shown to reduce gastric acid secretion
and volume. However, the optimal dose for effective GRV reduction in this
patient population remains uncertain. Aimed to assess the efficacy and safety of
two doses of Dexlansoprazole (30 mg and 60 mg) in reducing fasting GRV using
ultrasonography in diabetic patients scheduled for elective surgery.
Materials and Methods: A double-blind comparative study was conducted on
184 diabetic patients, randomized into two groups: DL30 (30 mg
Dexlansoprazole) and DL60 (60 mg Dexlansoprazole). Gastric volume was
measured using ultrasound in supine and right lateral decubitus positions.
Additional assessments included glycemic parameters, fasting duration, and
postoperative nausea and vomiting. Statistical analysis were performed using
SPSS Version 20, with p<0.05 considered significant.
Results: The DL60 group showed a significant reduction in GRV (28.32 ± 7.58
mL) compared to the DL30 group (39.72 ± 8.54 mL, p<0.05). There was a
significantly lower incidence of regurgitation (3.3% vs. 15.2%) and aspiration
risk (7.6% vs. 29.3%) in the DL60 group (p<0.05). Demographic variables, ASA
grade, and glycemic parameters were comparable between the groups.
Docusign Envelope ID: C4919C2A-827A-4EC9-931C-040F57A5388F
Docusign Envelope ID: C4919C2A-827A-4EC9-931C-040F57A5388F
Conclusion: A higher dose of Dexlansoprazole (60 mg) is more effective and
safer in reducing fasting gastric residual volume and minimizing aspiration risk
in diabetic patients undergoing elective surgery. These findings suggest that 60
mg Dexlansoprazole should be preferred for preoperative gastric volume
reduction in high-risk patients.
