Gastric Ultrasound as a Predictor of Postoperative Vomiting in Pediatric Emergency Surgery: A Randomized Controlled Study

Background:Postoperative nausea and vomiting (PONV) are common in pediatric surgery. This study compared peri-operative risk factors and gastric volume using ultrasound in pediatric traumatic and non-traumatic emergency surgeries.Methods:A double-blinded RCT at Aswan University Hospital included 50 patients (2-13 years) undergoing urgent surgery. Gastric ultrasound measured anteroposterior diameter (APD), craniocaudal diameter (CCD), and cross-sectional area (CSA) in supine and right lateral decubitus (RLD) positions. Risk scores for PONV were calculated, and data were analyzed using R software.Results:Traumatic cases (82%) showed lower risk scores than non-traumatic cases (p<0.001). In the RLD position, non-traumatic cases had higher APD (p=0.03). Pre-operative vomiting cases were older (10 vs. 5 years, p=0.001) and had higher risk scores (p<0.001). CCD was smaller in non-vomiting cases in the supine position (p=0.011). No significant differences were found in predicted gastric volume.Conclusion:Gastric ultrasound aids in assessing peri-operative risk in pediatric emergency surgery. Individualized risk assessment is crucial, particularly in traumatic cases and younger patients. Gastric ultrasound can help refine risk assessment and perioperative management strategies for pediatric emergency surgeries.