Gastric emptying after elective abdominal aortic aneurysm surgery: The case for early postoperative enteral feeding

Objective: to assess gastric emptying with a view to early postoperative en teral nutrition after elective abdominal aortic aneurysm (AAA) surgery. Methods: the paracetamol absorption test was used to assess gastric emptyin g in 13 consecutive patients at 6, 18 and 32 h following elective AAA surge ry. All patients received postoperative analgesia with marcaine given via a n epidural catheter during the first 48 postoperative hours. Normal emptyin g was defined as an area tinder the plasma paracetamol concentration curve at 60 min (AUC-60) of >600 mg/min/l. Results: the median time to normal gastric emptying was 18 +/- 7.7 h. One p atient (7.6%) had normal emptying at 6 h, nine (69%) at 18 h and 12 (92%) a t 32 h. The nasogastric tubes were removed at a median of 3.2 days after su rgery, and enteral feeding was commenced an day 4. Conclusions: gastric emptying was normal 18 h post-AAA surgery as assessed by the paracetamol absorption test. In view of the importance of maintainin g an intact gastrointestinal mucosa, enteral nutrition may be commenced on the second postoperative day.