Measurement of Gastric Residual Volume via Ultrasound after Receiving Intravenous Ondansetron, Metoclopramide, and Neostigmine in Critically Ill Patients: A Double-Blind Clinical Trial

Farzanegan, Behrooz; Shafigh, Navid; Heshmatnia, Jalal; Hashemian, Seyed Mohammadreza; Malekshoar, Mehran; Afzal, Golnaz; Jamaati, Hamidreza; Kazempour-Dizaji, Mehdi; Fathi, Mohammad

Measurement of Gastric Residual Volume via Ultrasound after Receiving Intravenous Ondansetron, Metoclopramide, and Neostigmine in Critically Ill Patients: A Double-Blind Clinical Trial

Document Type : Original Article

Authors

Behrooz Farzanegan ¹

Navid Shafigh ²

Jalal Heshmatnia ³

Seyed Mohammadreza Hashemian ³

Mehran Malekshoar ³

Golnaz Afzal ⁴

Hamidreza Jamaati ³

Mehdi Kazempour-Dizaji ⁵

Mohammad Fathi ¹

¹ Critical Care Quality Improvement Research Center, Department of Anaesthesiology, Shahid Beheshti University of Medical Sciences, Tehran, Iran

² Department of Anesthesiology and Critical Care Medicine, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran

³ Chronic Respiratory Diseases Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran

⁴ Department of Clinical Pharmacy, School of Pharmacy, Shahid Beheshti University of Medical Sciences, Tehran, Iran

⁵ Mycobacteriology Research Center, NRITLD, Shahid Beheshti University of Medical Sciences, Tehran, Iran

Abstract

Background: Gastric residual volume (GRV) is considered an important parameter for gastric emptying and nutrition tolerance. This volume is measured before any nutrition and has a direct effect on the volume and timing of the next nutrition. The present study aimed to examine the GRV via ultrasound after receiving intravenous ondansetron, metoclopramide, and neostigmine.
Materials and Methods: In the present study, 40 patients were included in the study, 10 patients were excluded from the study due to death during treatment, and 30 patients were divided into three groups of 10(10 patients in each group).The first, second, and third groups received 2.5, 10, and 8 mg neostigmine, metoclopramide, and ondansetron every 8 h, respectively. The drugs were infused as a micro set in 100 ml normal saline into patients within 30 min. The patients underwent ultrasound imaging and GRV measurement by an intensive care unit (ICU) subspecialty fellow, who was not aware of the drugs received by the patients, in the 1^st h of hospitalization, 6 h after drug injection, and once daily for 4 days.
Results: A total of 40 patients entered the study based on inclusion and exclusion criteria. The effect of neostigmine on reducing GRV (Gastric residual volume) in ICU patients was better than those of the other two drugs, which was significant.
Conclusion: The results of this study showed that neostigmine has a better and significant effect on reducing GRV in ICU patients, compared to those of ondansetron and metoclopramide.

Keywords

Ondansetron

Metoclopramide

Neostigmine

Gastric residual volume