12 Pre-anaesthetic fasting and aspiration

Abstract

The incidence of pulmonary aspiration of gastric content according to prospective and retrospective studies lies between 1.4 and 4.7 aspirations per 10 000 operations. Mortality has decreased to 1/71 829 anaesthesias. Reasons for an increased incidence of aspiration are higher American Society of Anesthetists status, emergency surgery, pregnancy and intestinal obstruction. New guidelines for elective surgical patients include no solid food for 6–8 hours but clear fluids up to 2 hours before operation. Acid antagonists and gastrokinetics should be given to patients with increased risk.