Assessment of preoperative preventive measures for pulmonary aspiration in surgical patients: A cross-sectional study

Background

Pulmonary aspiration of gastric contents is a rare but catastrophic cause of anesthesia related morbidity and mortality of surgical patients. The risk of pulmonary aspiration is high in surgical patient due to multiple factors. The aim of this study was to assess the practice of aspiration prevention and prophylaxis usage for patients prior to surgery.

Method

A cross-sectional study was conducted from 10 April 2022 to 20 April 2022. Data were collected by the direct observation and patient interview. The standards were directly changed in to questionnaire form with two integral components ‘yes’ and ‘no”. Data were entered and analyzed using statistical package of social sciences (SPSS) version 20.

Result

A total of 200 surgical patients were included with a response rate of 100%. Preoperative information provision to elective surgical patients on fasting requirements and the reason for them in advance of their procedures was implemented in 63% of the patients. The verification of fasting requirement was provided in 94% of elective patients. About 62.5% of elective surgical patients received gastrointestinal stimulants preoperatively. Metoclopromide was administered for 94% of emergency patients.

Conclusion and recommendation

The practice of preoperative fasting and administration of prophylactic agents for pulmonary aspiration is quite limited in our setup. Moreover, adherence to the recommendations of American Society of Anesthesiologist (ASA) and European Society of Anesthesiologist (ESA) was also suboptimal. We strongly recommend clinicians to use appropriate prophylactic agent to the right patient and adherence of the clinician to the local guideline on prevention of pulmonary aspiration.