Impact of preoperative oral domperidone on gastric residual volume after clear fluid ingestion in patients scheduled for elective surgery: a randomized controlled trial

Introduction:
Oral domperidone is a prokinetic drug that enhances gastric emptying, which has a positive effect in decreasing gastric residual volume (GRV), subsequently decreasing the risk of pulmonary aspiration. This study aimed to assess the effect of preoperative oral domperidone on gastric residual volume, detected by ultrasound for patients undergoing elective surgery under general anesthesia.

Material and methods:
This randomized double-blinded controlled placebo trial was conducted in 40 patients who were randomly assigned to two equal groups: the domperidone group (D) (n = 20): patients received 400 mL of apple juice as a clear fluid, two hours preoperatively, and an oral domperidone 10 mg tablet; and the placebo group (P) (n = 20): patients received 400 mL of apple juice as a clear fluid two hours preoperatively with a placebo tablet. Gastric residual volume detected by ultrasound was the primary outcome and postoperative nausea and vomiting (PONV) was the secondary outcome.

Results:
There was no statistically significant difference in the mean gastric residual volume detected by ultrasound between groups after 1 hour (P > 0.05). However, the mean gastric residual volume detected by ultrasound after 2 hours was statistically significantly lower with domperidone (55.95 ± 6.72 mL) than with the placebo group (70.22 ± 13.00 mL) (P < 0.05). There was no statistically significant difference between groups regarding PONV, with a P-value > 0.05.

Conclusions:
Preoperative oral domperidone intake was effective in decreasing the GRV measured by ultrasound.