Efficacy and safety of two different doses of Dexlansoprazole in assessing fasting gastric residual volume by using ultrasonography in diabetic patients undergoing elective surgery

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.