The DOI matches its Crossref record; 161 of the 161 references it cites were found in a registry or an index.
Gastroesophageal Reflux and Aspiration of Gastric Contents in Anesthetic Practice
Abstract
General anesthesia may predispose patients to aspiration of gastroesophageal contents because of depression of protective reflexes during loss of consciousness. In addition, some patients may be at increased risk of pulmonary aspiration because of retention of gastric contents caused by pain, inadequate starvation, or gastrointestinal pathology resulting in reduced gastric emptying and gastroesophageal reflux. Despite increasing knowledge of the problems associated with aspiration, the relatively small incidence and associated mortality rates in the perioperative period do not appear to have changed markedly over the last few decades. In this review article, the physiological factors associated with an increased risk of gastroesophageal reflux and aspiration are considered together with some of the methods that are used to prevent aspiration. In particular, preoperative starvation, the use of drugs designed to increase gastric pH, recent developments in airway devices, and appropriate application of cricoid pressure are critically appraised.
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In the citing paper
“General anesthesia inherently increases the risk of aspiration because of a combination of factors, including diminished airway protective reflexes, decreased lower esophageal sphincter tone, and the use of positive pressure ventilation.”
From Delayed gastric emptying induced by glucagon-like peptide-1 receptor agonists and its implications for perioperative risk during anesthesia (2026) · cites this paper as [41]
In the citing paper
“This risk is particularly pronounced during tracheal intubation and extubation [41].”
From Delayed gastric emptying induced by glucagon-like peptide-1 receptor agonists and its implications for perioperative risk during anesthesia (2026) · cites this paper as [41]
Citations
Cites
CRICOID PRESSURE TO CONTROL REGURGITATION OF STOMACH CONTENTS DURING INDUCTION OF ANÆSTHESIA
Sellick, B. A. (1961) · The Lancet · doi:10.1016/s0140-6736(61)92485-0 · Cited by 951
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Continuous Aspiration of Subglottic Secretions in Preventing Ventilator-Associated Pneumonia
Valles, J., Artigas, A., Rello, J., Bonsoms, N., Fontanals, D., Blanch, L., Fernandez, R., Baigorri, F., & Mestre, J. (1995) · Annals of Internal Medicine · doi:10.7326/0003-4819-122-3-199502010-00004 · Cited by 549
Aspiration during anaesthesia: a computer‐aided study of 185 358 anaesthetics
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Aspiration in severe trauma: a prospective study
Lockey, D., Coats, T., & Parr, M. J. (1999) · Anaesthesia · doi:10.1046/j.1365-2044.1999.00754.x · Cited by 510
The LMA ‘ProSeal’—a laryngeal mask with an oesophageal vent
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Cited by
Kang, D., & Choi, D. (2026) · The Korean Journal of Internal Medicine · doi:10.3904/kjim.2025.277 · Cited by 1
“This risk is particularly pronounced during tracheal intubation and extubation [41].”
Metadata
- Authors
- Ng, A., & Smith, G.
- Affiliations
- Leicester Royal Infirmary (GB)
- Corresponding author
- Smith, Graham
- Venue
- Anesthesia & Analgesia
- Published
- 2001-08
- Volume
- 93
- Issue
- 2
- Pages
- 494-513
- ISSN
- 0003-2999 (ISSN-L)
- OpenAlex
- W4234912042
- Cited by
- 241
- References
- 161
- Citations by year
- 2026: 11 · 2025: 9 · 2024: 9 · 2023: 10 · 2022: 6 · 2021: 6 · 2020: 6 · 2019: 4 · 2018: 6 · 2017: 13 · 2016: 11 · 2015: 7 · 2014: 11 · 2013: 7 · 2012: 17
- FWCI
- 1.74
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Anesthesia & Analgesia (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Anesthesiology and Pain Medicine › Airway Management and Intubation Techniques
- Health Sciences › Medicine › Anesthesiology and Pain Medicine › Anesthesia and Sedative Agents
- Health Sciences › Medicine › Surgery › Nausea and vomiting management
- Keywords
- gastroesophageal reflux, gastric aspiration, pulmonary aspiration, general anesthesia, preoperative fasting, gastric emptying, gastric acid suppression, airway devices, cricoid pressure, aspiration prevention, perioperative mortality
- MeSH terms
- Anesthesia, Animals, Gastric Acidity Determination, Gastric Emptying, Gastroesophageal Reflux, Humans, Intubation, Gastrointestinal, Neuromuscular Blocking Agents, Pneumonia, Aspiration, Laryngeal Masks
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- Ng, A., & Smith, G. (2001). Gastroesophageal Reflux and Aspiration of Gastric Contents in Anesthetic Practice. Anesthesia & Analgesia. https://doi.org/10.1213/00000539-200108000-00050
Data sources
Bibliographic data: Semantic Scholar, OpenAlex, Crossref.
Contains information from the Semantic Scholar Academic Graph Datasets, made available under the ODC Attribution License (ODC-BY 1.0).
Semantic Scholar’s data is described in: Kinney, R., et al. (2023). The Semantic Scholar Open Data Platform. arXiv:2301.10140.
