SHM Converge Scientific Abstract ePoster Gallery-Gastric Point-of-Care Ultrasound (Pocus) as a Perioperative Risk Assessment Tool in Hospitalized Patients Prescribed Methadone for Opiate Use Disorder

Gastric Point-of-Care Ultrasound (Pocus) as a Perioperative Risk Assessment Tool in Hospitalized Patients Prescribed Methadone for Opiate Use Disorder

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This prospective observational cohort study evaluated whether gastric point-of-care ultrasound (POCUS) can help assess perioperative aspiration risk in hospitalized patients prescribed methadone for opioid use disorder. Methadone is known to slow gastric emptying, and standard American Society of Anesthesiologists fasting guidelines may not reliably ensure an empty stomach.<br /><br />Hospitalized patients on methadone were scanned after an overnight fast. Each patient underwent four gastric POCUS scans: two in the supine position and two in the right-lateral decubitus position. The gastric antrum was measured, and a blinded expert classified each stomach as empty, liquid, or solid. Patient characteristics were then compared between those with “safe” versus “not safe” stomachs.<br /><br />The main finding was that two-thirds of patients had a non-empty stomach despite fasting at least 8 hours. This suggests that an 8-hour fast may be insufficient for many inpatients taking methadone before surgery or procedures, and that gastric POCUS may be useful for preoperative risk stratification. In the small sample, higher methadone dose, chronic methadone use, and calcium channel blocker use were associated with non-empty stomachs.<br /><br />The authors conclude that gastric POCUS may be a valuable tool for identifying aspiration risk in this population and helping guide anesthetic planning. Further research is needed to identify predictors of delayed gastric emptying in methadone-treated patients and to determine safest perioperative management strategies.

Asset Subtitle

Nicholas Samel

Meta Tag

Author List Benjamin Galen, Brett E. Fortune, Daniel Alvarez, Nicholas Samel, Paola Mejia

Category Research

Concept Gastric Ultrasound

Concept Methadone

Concept Non-empty Stomach

Concept Perioperative Aspiration Risk

Concept Gastric Emptying

Distinguished Non-Finalist

Presenter Organization Albert Einstein College of Medicine

Presenting Author Nicholas Samel

Track Perioperative

Keywords

gastric POCUS

methadone

opioid use disorder

aspiration risk

perioperative assessment

gastric emptying

fasting guidelines

antral ultrasound

anesthesia planning

hospitalized patients

Gastric Ultrasound

Methadone

Non-empty Stomach

Perioperative Aspiration Risk

Gastric Emptying