Cited by 241Airway Management and Intubation TechniquesAnesthesia and Sedative AgentsNausea and vomiting management

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Gastroesophageal Reflux and Aspiration of Gastric Contents in Anesthetic Practice

Ng, Alexander, Smith, Graham·2001·Anesthesia & Analgesia

DOI 10.1213/00000539-200108000-00050

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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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Delayed gastric emptying induced by glucagon-like peptide-1 receptor agonists and its implications for perioperative risk during anesthesia
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See all 241

Authors: Ng, A., & Smith, G.
Affiliations: Leicester Royal Infirmary (GB)
Corresponding author: Smith, Graham
Venue: Anesthesia & Analgesia
Publisher: Ovid Technologies (Wolters Kluwer Health)
Published: 2001-08
Volume: 93
Issue: 2
Pages: 494-513
ISSN: 0003-2999 (ISSN-L)
DOI: 10.1213/00000539-200108000-00050
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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Gastroesophageal Reflux and Aspiration of Gastric Contents in Anesthetic Practice

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