Effect of different cervical spine pathologies on gastric emptying, using bed side ultrasound in adults patients- A prospective observational study.

Cervical spine pathologies, both traumatic and non-traumatic, are associated not only with motor and sensory deficits but also with significant autonomic dysfunction, including gastrointestinal (GI) motility disturbances. Disruption of sympathetic outflow with preserved vagal tone may lead to delayed gastric emptying (DGE), increasing the risk of aspiration during anesthesia, particularly in patients with anticipated difficult airways. Despite the clinical relevance, there is limited literature comparing gastric emptying patterns across different cervical spine pathologies.

This prospective observational study aims to assess the effect of cervical spine diseases—classified as acute or chronic, traumatic or non-traumatic—on gastric emptying using bedside ultrasound. The study will recruit adult patients (aged 18–60 years) scheduled for elective cervical spine surgery, ASA I–II, over a period of one year at Nizam’s Institute of Medical Sciences. Exclusion criteria include emergency surgeries, ASA III–IV status, long-standing diabetes, chronic renal failure, GERD, BMI >40, polytrauma, and autonomic neuropathy.

Gastric volume will be assessed using a curvilinear probe (2–5 MHz) in the right lateral position. The antral cross-sectional area (ACSA) will be measured using anteroposterior and craniocaudal diameters, and gastric volume will be calculated using the Perlas formula:

Volume (mL) = 27 + 14.6 × ACSA (cm²) – 1.28 × age

Baseline gastric volume (after 8 hours fasting) and postprandial volume (4 hours after a standard breakfast) will be recorded. Each time, three ultrasound readings will be averaged. Additional variables including type and duration of cervical pathology, use of cervical collar, neurological deficits, and comorbidities will also be documented.

The study aims to identify high-risk subgroups requiring tailored fasting guidelines to optimize perioperative safety and minimize aspiration risk.