Black or white coffee before anaesthesia?: A randomised crossover trial

作者：Larsen Birgit^*; Larsen Lars P; Sivesgaard Kim; Juul Svend

来源：European Journal of Anaesthesiology, 2016, 33(6): 457-462.

DOI：10.1097/EJA.0000000000000457

BACKGROUNDIn current preoperative fasting guidelines, coffee with milk is still regarded by many as solid food. Evidence on the consequences for gastric volume of adding milk to coffee 2h before anaesthesia is still weak.OBJECTIVESThe aim of this study was to compare the gastric volume by MRI in healthy volunteers after drinking coffee with and without added milk.DESIGNA randomised crossover trial where all participants were exposed to three coffee and milk mixtures performed as a noninferiority study with a predefined noninferiority limit of 12ml.SETTINGDepartment of Day Surgery and Department of Radiology, Aarhus University Hospital, Aarhus, Denmark. The study was conducted between August 2013 and February 2014.PARTICIPANTSTotal 32 healthy volunteers, aged 18 to 71 years.INTERVENTIONSThe participants fasted for 6h for solid food, and 2h before the MRI examination of gastric volume, each participant ingested one of three coffee mixtures: 175ml coffee, including either 0 or 20 or 50% full fat milk. Each participant was studied by MRI three times separated by a minimum time interval of 2 days. The order of coffee mixture ingested was determined by random allocation.MAIN OUTCOME MEASUREGastric volume as measured by MRI.RESULTSThe mean gastric volume for black coffee was 27.8ml, for coffee with 20% milk 17.9ml and for coffee with 50% milk 20.6ml. Compared to black coffee, the gastric volume for 20% milk was significantly decreased with a difference of -10.0ml (95% confidence interval, -18.2, -1.8), and for 50% milk it was insignificantly decreased, -7.2ml (95% confidence interval, -17.4, +2.9). The upper confidence interval for the difference in gastric volume between the no milk added' group and each milk added' group did not reach the noninferiority limit of 12ml.CONCLUSIONThe study provides evidence that adding up to 50% full fat milk to coffee leads to no or only a minimal increase of the gastric volume 2h later. The results support a liberalisation of policy on the addition of milk to hot drinks before planned anaesthesia.TRIAL REGISTRATIONwww.Clinicaltrials.gov identifier: NCT02361632.

• 出版日期2016-6