Acid aspiration syndrome prophylaxis in gynaecological and obstetric patients. A Norwegian survey

Acta Anaesthesiol Scand. 1994 Nov;38(8):863-8. doi: 10.1111/j.1399-6576.1994.tb04019.x.

Abstract

Clinical practice and attitudes of Acid Aspiration Syndrome (AAS) prevention in connection with gynaecological and obstetric surgery were surveyed in all Norwegian departments of anaesthesia. General anaesthesia with rapid-sequence intubation using succinylcholine and cricoid pressure was the preferred method for all emergency surgery, except Caesarian section (C-section) where 58% of the departments reported use of spinal or epidural anaesthesia if time allowed for its use. Chemoprophylaxis was more often used before emergency C-section (60%) than before emergency gynaecological surgery (14%), and mostly consisted of the antacid sodium citrate given alone. Seventy-six percent of the departments used mechanical emptying of the stomach before emergency gynaecological surgery and 44% before emergency C-section. While all responders considered recent intake of a "light breakfast" in an elective patient to be a risk factor of AAS indicating delay of surgery or use of specific precautions like regional anaesthesia, rapid-sequence intubation, or chemoprophylaxis, 52-72% of the responders considered obesity, dyspepsia, recent water intake, smoking or use of chewing gum to be risk factors as well. We think this survey demonstrates a need for consensus discussions of AAS prophylaxis.

MeSH terms

  • Anesthesia, General / adverse effects*
  • Anesthesia, General / methods
  • Anesthesia, Obstetrical / adverse effects*
  • Anesthesia, Obstetrical / methods
  • Attitude of Health Personnel
  • Cesarean Section
  • Female
  • Genitalia, Female / surgery*
  • Humans
  • Pneumonia, Aspiration / etiology
  • Pneumonia, Aspiration / prevention & control*
  • Pregnancy
  • Pregnancy Complications / surgery
  • Risk Factors