Gastric Volumes by US in Term Parturients Undergoing CS With and Without Metoclopramide

NCT ID: NCT05033041

Last Updated: 2025-09-11

Study Results

Results available

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Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE4

Total Enrollment

72 participants

Study Classification

INTERVENTIONAL

Study Start Date

2021-10-20

Study Completion Date

2024-02-08

Brief Summary

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Our objective is to compare gastric volumes (mL) between women who receive metoclopramide versus placebo prior to scheduled cesarean delivery in appropriately fasted patients. If metoclopramide is found not to reduce gastric volumes this would inform future practice guidelines for obstetric anesthesia, which currently recommends metoclopramide administration prior to cesarean deliveries.

We hypothesize that metoclopramide given to women with appropriate fasting prior to cesarean delivery does not result in any clinically significant reduction in gastric volume (mL) and therefore does not provide any additional benefit for aspiration prophylaxis but may expose patients to unnecessary side effects. A secondary objective will be to evaluate if gastric volume is a significant predictor of intraoperative nausea and vomiting.

Detailed Description

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Conditions

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Pregnancy Cesarean Section Aspiration

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Randomized controlled blinded study
Primary Study Purpose

TREATMENT

Blinding Strategy

QUADRUPLE

Participants Caregivers Investigators Outcome Assessors
Research pharmacy to prepare the study medication blinding the participant, care providers, investigator and outcomes assessor.

Study Groups

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Group 1 Study Drug Metoclopramide

Intravenous administration of 10 mg metoclopramide

Group Type ACTIVE_COMPARATOR

Study drug metoclopramide

Intervention Type DRUG

Intravenous administration of 10 mg metoclopramide

Group 2 Study Drug Placebo

Intravenous administration of sterile normal saline

Group Type PLACEBO_COMPARATOR

Study drug placebo administration

Intervention Type DRUG

Intravenous administration of placebo (sterile normal saline)

Interventions

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Study drug metoclopramide

Intravenous administration of 10 mg metoclopramide

Intervention Type DRUG

Study drug placebo administration

Intravenous administration of placebo (sterile normal saline)

Intervention Type DRUG

Eligibility Criteria

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Inclusion Criteria

* Healthy (ASA Physical Status 2)
* Age \>18 years old
* Non-obese (BMI \<40 kg/m2)
* Age \>18 years
* Term (\>37 week)
* Non-laboring parturient
* Single gestation
* Scheduled for a cesarean delivery and NPO

Exclusion Criteria

* Systemic disease such as diabetes mellitus (type 1 or 2)
* Multiple gestation
* Abnormality of upper GI tract
* History of GI tract related surgical procedures
* Use of gastric motility medications
* Active labor
* Renal impairment (creatinine \>2)
* Non-English speaking
* Cognitively impaired
* History of QT prolongation
* Use of general anesthesia
Minimum Eligible Age

18 Years

Eligible Sex

FEMALE

Accepts Healthy Volunteers

No

Sponsors

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Northwestern University

OTHER

Sponsor Role lead

Responsible Party

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Jennifer Banayan

Principal Investigator

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Jennifer Banayan, MD

Role: PRINCIPAL_INVESTIGATOR

Northwestern University

Locations

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Northwestern Memorial Hospital and Prentice Women's Hospital

Chicago, Illinois, United States

Site Status

Countries

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United States

References

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Practice Guidelines for Preoperative Fasting and the Use of Pharmacologic Agents to Reduce the Risk of Pulmonary Aspiration: Application to Healthy Patients Undergoing Elective Procedures: An Updated Report by the American Society of Anesthesiologists Task Force on Preoperative Fasting and the Use of Pharmacologic Agents to Reduce the Risk of Pulmonary Aspiration. Anesthesiology. 2017 Mar;126(3):376-393. doi: 10.1097/ALN.0000000000001452. No abstract available.

Reference Type BACKGROUND
PMID: 28045707 (View on PubMed)

MENDELSON CL. The aspiration of stomach contents into the lungs during obstetric anesthesia. Am J Obstet Gynecol. 1946 Aug;52:191-205. doi: 10.1016/s0002-9378(16)39829-5. No abstract available.

Reference Type BACKGROUND
PMID: 20993766 (View on PubMed)

Practice Guidelines for Obstetric Anesthesia: An Updated Report by the American Society of Anesthesiologists Task Force on Obstetric Anesthesia and the Society for Obstetric Anesthesia and Perinatology. Anesthesiology. 2016 Feb;124(2):270-300. doi: 10.1097/ALN.0000000000000935. No abstract available.

Reference Type BACKGROUND
PMID: 26580836 (View on PubMed)

4. Knight M, Bunch K, Tuffnell D, Shakespeare J, Kotnis R, Kenyon S, Kurinczuk JJ (Eds.) on behalf of MBRRACE-UK. Saving Lives, Improving Mothers' Care - Lessons learned to inform maternity care from the UK and Ireland Confidential Enquiries into Maternal Deaths and Morbidity 2016-18. Oxford: National Perinatal Epidemiology Unit, University of Oxford 2020.

Reference Type BACKGROUND

Leus M, van de Ven A. IMAGES IN CLINICAL MEDICINE. An Acute Dystonic Reaction after Treatment with Metoclopramide. N Engl J Med. 2015 Oct;373(14):e16. doi: 10.1056/NEJMicm1412207. No abstract available.

Reference Type BACKGROUND
PMID: 26422744 (View on PubMed)

Mishriky BM, Habib AS. Metoclopramide for nausea and vomiting prophylaxis during and after Caesarean delivery: a systematic review and meta-analysis. Br J Anaesth. 2012 Mar;108(3):374-83. doi: 10.1093/bja/aer509. Epub 2012 Feb 3.

Reference Type BACKGROUND
PMID: 22307240 (View on PubMed)

Paranjothy S, Griffiths JD, Broughton HK, Gyte GM, Brown HC, Thomas J. Interventions at caesarean section for reducing the risk of aspiration pneumonitis. Cochrane Database Syst Rev. 2010 Jan 20;(1):CD004943. doi: 10.1002/14651858.CD004943.pub3.

Reference Type BACKGROUND
PMID: 20091567 (View on PubMed)

Perlas A, Mitsakakis N, Liu L, Cino M, Haldipur N, Davis L, Cubillos J, Chan V. Validation of a mathematical model for ultrasound assessment of gastric volume by gastroscopic examination. Anesth Analg. 2013 Feb;116(2):357-63. doi: 10.1213/ANE.0b013e318274fc19. Epub 2013 Jan 9.

Reference Type BACKGROUND
PMID: 23302981 (View on PubMed)

Van de Putte P, Perlas A. Ultrasound assessment of gastric content and volume. Br J Anaesth. 2014 Jul;113(1):12-22. doi: 10.1093/bja/aeu151. Epub 2014 Jun 3.

Reference Type BACKGROUND
PMID: 24893784 (View on PubMed)

Arzola C, Perlas A, Siddiqui NT, Carvalho JCA. Bedside Gastric Ultrasonography in Term Pregnant Women Before Elective Cesarean Delivery: A Prospective Cohort Study. Anesth Analg. 2015 Sep;121(3):752-758. doi: 10.1213/ANE.0000000000000818.

Reference Type BACKGROUND
PMID: 26097988 (View on PubMed)

Arzola C, Perlas A, Siddiqui NT, Downey K, Ye XY, Carvalho JCA. Gastric ultrasound in the third trimester of pregnancy: a randomised controlled trial to develop a predictive model of volume assessment. Anaesthesia. 2018 Mar;73(3):295-303. doi: 10.1111/anae.14131. Epub 2017 Dec 19.

Reference Type BACKGROUND
PMID: 29265187 (View on PubMed)

Provided Documents

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Document Type: Study Protocol and Statistical Analysis Plan

View Document

Other Identifiers

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STU00215570

Identifier Type: -

Identifier Source: org_study_id

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