The Bottom Line - June 24, 2016 - By Duncan Chambler
Erythromycin for Gastric Emptying in Patients Undergoing General Anesthesia for Emergency Surgery. Czarnetzki. JAMA Surg. 2015; 150:730-7. doi:10.1001/jamasurg.2015.0306
"Clinical Question
- In adult patients undergoing general anaesthesia for emergency surgery, does pre-medication with erythromycin compared to placebo reduce the volume of gastric content?
The Bottom Line
- This single centre RCT has methodological concerns that reduce the internal validity and external generalisability
- Erythromycin may reduce residual gastric content and acidity but this trial does not demonstrate sufficient statistical significance to reject the null hypothesis
- Any benefit occurs at the expense of unpleasant side effects with equal incidence to the intended benefit
- Whilst the authors should be commended for thinking laterally and investigating this novel idea, I shall not be using erythromycin prior to rapid sequence induction of anaesthesia"