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Factors Influencing Intraoperative Gastric Regurgitation: A Prospective Random Study of Nasogastric Tube Drainage

Factors Influencing Intraoperative Gastric Regurgitation: A Prospective Random Study of... Abstract • A prospective study was conducted to determine the incidence of "silent" gastric regurgitation and aspiration during general anesthesia in 146 patients randomized with respect to presence of a nasogastric tube. A bland dye was instilled in the stomach to serve as the determinant marker. The overall incidence of regurgitation was 8.9% and of aspiration, 2.1% in spite of the uniform use of an endotracheal tube. The incidence of regurgitation was twice as high when anesthesia was given by an inexperienced anesthetist (11% vs 5.6%) and in patients without nasogastric tubes (12% vs 6%), although such differences were not statistically significant. The primary agent used, difficulty of endotracheal intubation, location of surgical incision, and duration of anesthesia did not alter the incidence of regurgitation or aspiration. No correlation was found between the detection of subclinical aspiration and the development of postoperative pulmonary complications. (Arch Surg 113:721-723, 1978) References 1. Mendelson CL: The aspiration of stomach contents into the lungs during obstetric anesthesia . Am J Obstet Gynecol 52:191-205, 1946. 2. Edwards G, Morton HJV, Wylie WD: Deaths associated with anesthesia: Report of 1,000 cases . Anesthesiology 11:194-222, 1956. 3. Culver GA, Makel HP, Beecher HK: Frequency of aspiration of gastric contents by the lungs during anesthesia and surgery . Ann Surg 133:289-292, 1951.Crossref 4. Blitt CD, Gutman HL, Cohen DD, et al: "Silent" regurgitation and aspiration during general anesthesia . Anesth Analg 49:707-713, 1970.Crossref 5. Berson J, Adriani J: "Silent" regurgitation and aspiration during anesthesia . Anesthesiology 15:644-649, 1954.Crossref 6. Amberson JB: Aspiration bronchopneumonia . Int Clinics 3:126-138, 1937. 7. Gardner AMN: Aspiration of food and vomit . Q J Med 106:227-245, 1958. 8. Chase HF: Role of delayed gastric emptying time in the etiology of aspiration pneumonia . Am J Obstet Gynecol 56:673-679, 1948. 9. Cameron JL, Reynolds J, Zuidema GD: Aspiration in patients with tracheostomies . Surg Gynecol Obstet 136:68-70, 1973. 10. Teabeaut JR: Aspiration of gastric contents: Experimental study . Am J Pathol 28:51-62, 1952. 11. Roberts RB, Shirley MA: Reducing the risk of acid aspiration during caeserean section . Anesth Analg 53:859-868. 1976.Crossref 12. Hester JB, Heath ML: Pulmonary acid aspiration syndrome: Should prophylaxis be routine? Br J Anaesth 47:630-631, 1975.Crossref 13. Taylor G: Acid pulmonary aspiration syndrome after antacids: A case report . Br J Anaesth 47:615-617, 1975.Crossref 14. Hutchinson BR, Newson AJ: Preoperative neutralization of gastric acidity . Anaesth Intensive Care 3:198-203, 1975. 15. Cameron JL, Mitchell WH, Zuidema GD: Aspiration pneumonia: Clinical outcome following documented aspiration . Arch Surg 106:49-52, 1973.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Surgery American Medical Association

Factors Influencing Intraoperative Gastric Regurgitation: A Prospective Random Study of Nasogastric Tube Drainage

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Publisher
American Medical Association
Copyright
Copyright © 1978 American Medical Association. All Rights Reserved.
ISSN
0004-0010
eISSN
1538-3644
DOI
10.1001/archsurg.1978.01370180063008
Publisher site
See Article on Publisher Site

Abstract

Abstract • A prospective study was conducted to determine the incidence of "silent" gastric regurgitation and aspiration during general anesthesia in 146 patients randomized with respect to presence of a nasogastric tube. A bland dye was instilled in the stomach to serve as the determinant marker. The overall incidence of regurgitation was 8.9% and of aspiration, 2.1% in spite of the uniform use of an endotracheal tube. The incidence of regurgitation was twice as high when anesthesia was given by an inexperienced anesthetist (11% vs 5.6%) and in patients without nasogastric tubes (12% vs 6%), although such differences were not statistically significant. The primary agent used, difficulty of endotracheal intubation, location of surgical incision, and duration of anesthesia did not alter the incidence of regurgitation or aspiration. No correlation was found between the detection of subclinical aspiration and the development of postoperative pulmonary complications. (Arch Surg 113:721-723, 1978) References 1. Mendelson CL: The aspiration of stomach contents into the lungs during obstetric anesthesia . Am J Obstet Gynecol 52:191-205, 1946. 2. Edwards G, Morton HJV, Wylie WD: Deaths associated with anesthesia: Report of 1,000 cases . Anesthesiology 11:194-222, 1956. 3. Culver GA, Makel HP, Beecher HK: Frequency of aspiration of gastric contents by the lungs during anesthesia and surgery . Ann Surg 133:289-292, 1951.Crossref 4. Blitt CD, Gutman HL, Cohen DD, et al: "Silent" regurgitation and aspiration during general anesthesia . Anesth Analg 49:707-713, 1970.Crossref 5. Berson J, Adriani J: "Silent" regurgitation and aspiration during anesthesia . Anesthesiology 15:644-649, 1954.Crossref 6. Amberson JB: Aspiration bronchopneumonia . Int Clinics 3:126-138, 1937. 7. Gardner AMN: Aspiration of food and vomit . Q J Med 106:227-245, 1958. 8. Chase HF: Role of delayed gastric emptying time in the etiology of aspiration pneumonia . Am J Obstet Gynecol 56:673-679, 1948. 9. Cameron JL, Reynolds J, Zuidema GD: Aspiration in patients with tracheostomies . Surg Gynecol Obstet 136:68-70, 1973. 10. Teabeaut JR: Aspiration of gastric contents: Experimental study . Am J Pathol 28:51-62, 1952. 11. Roberts RB, Shirley MA: Reducing the risk of acid aspiration during caeserean section . Anesth Analg 53:859-868. 1976.Crossref 12. Hester JB, Heath ML: Pulmonary acid aspiration syndrome: Should prophylaxis be routine? Br J Anaesth 47:630-631, 1975.Crossref 13. Taylor G: Acid pulmonary aspiration syndrome after antacids: A case report . Br J Anaesth 47:615-617, 1975.Crossref 14. Hutchinson BR, Newson AJ: Preoperative neutralization of gastric acidity . Anaesth Intensive Care 3:198-203, 1975. 15. Cameron JL, Mitchell WH, Zuidema GD: Aspiration pneumonia: Clinical outcome following documented aspiration . Arch Surg 106:49-52, 1973.Crossref

Journal

Archives of SurgeryAmerican Medical Association

Published: Jun 1, 1978

References