Masui. The Japanese journal of anesthesiology
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Examination of the literature suggests that the incidence of aspiration pneumonia in the perioperative period is relatively infrequent. Since Mendelson's report of aspiration pneumonitis in 1946, the factors that contribute to the likelihood of aspiration have been identified, and numerous attempts for preventions for regurgitation or pulmonary aspiration have been made. ⋯ Second generation supraglottic airways may not reduce the risk of regurgitation, but may reduce the chance of aspiration if the mask position is correct and drain tube works well. Because the mortality and morbidity of aspiration pneumonia remain relatively high, the preoperative risk evaluation is very important to avoid regurgitation or aspiration.
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Review
[Risk Factors of Perioperative Pulmonary Aspiration Related to Anesthesia, Devices and Operation].
Perioperative pulmonary aspiration is an infrequent but is still a leading cause of anesthesia-related morbidity and mortality. This article reviews risk factors of perioperative pulmonary aspiration related to anesthesia, devices and operation. The most consistent risk factors related to anesthesia are light anesthesia, residual neuromuscular blockade after anesthesia, intermittent positive pressure ventilation particularly with high airway pressure, and prolonged anesthesia. ⋯ Even if patients have no predisposing factors, they may become at risk of pulmonary aspiration from a surgical procedure. Patients who are undergoing emergency procedures, bariatric surgery, upper abdominal surgery and laparoscopic surgery should be considered at risk. Lithotomy or the head-down position may also encourage residual gastric contents to regurgitate.