title: Acid aspiration syndrome prophylaxis in gynaecological and obstetric patients. A Norwegian survey.
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.
authors.affiliation: Department of Anaesthesiology, Rogaland Central Hospital, Stavanger, Norway.
authors.forename: E
authors.initials: E
authors.lastname: Søreide
authors.forename: H
authors.initials: H
authors.lastname: Holst-Larsen
authors.forename: P A
authors.initials: PA
authors.lastname: Steen
mesh_terms: D000768:Anesthesia, General / Q000009:adverse effects* / Q000379:methods; D000773:Anesthesia, Obstetrical / Q000009:adverse effects* / Q000379:methods; D001291:Attitude of Health Personnel; D002585:Cesarean Section; D005260:Female; D005836:Genitalia, Female / Q000601:surgery*; D006801:Humans; D011015:Pneumonia, Aspiration / Q000209:etiology / Q000517:prevention & control*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000601:surgery; D012307:Risk Factors