ACID ASPIRATION SYNDROME PROPHYLAXIS IN GYNECOLOGICAL AND OBSTETRIC PATIENTS - A NORWEGIAN SURVEY

Clinical practice and attitudes of Acid Aspiration Syndrome (AAS) prev ention in connection with gynaecological and obstetric surgery were su rveyed in all Norwegian departments of anaesthesia. General anaesthesi a with rapid-sequence intubation using succinylcholine and cricoid pre ssure was the preferred method for all emergency surgery, except Caesa rian section (C-section) where 58% of the departments reported use of spinal or epidural anaesthesia if time allowed for its use. Chemoproph ylaxis was more often used before emergency C-section (60%) than befor e emergency gynaecological surgery (14%), and mostly consisted of the antacid sodium citrate given alone. Seventy-six percent of the departm ents used mechanical emptying of the stomach before emergency gynaecol ogical surgery and 44% before emergency C-section. While all responder s considered recent intake of a ''light breakfast'' in an elective pat ient to be a risk factor of AAS indicating delay of surgery or use of specific precautions like regional anaesthesia, rapid-sequence intubat ion, or chemoprophylaxis, 52-72% of the responders considered obesity, dyspepsia, recent water intake, smoking or use of chewing gum to be r isk factors as well. We think this survey demonstrates a need for cons ensus discussions of AAS prophylaxis.