HISTORICAL AND EXPERIMENTAL STUDY OF ASPIRATION OF GASTRIC AND OESOPHAGEAL CONTENTS INTO THE LUNGS IN ANAESTHESIA

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Abstract
The history of aspiration of gastric contents into the lungs in anaesthesia is reviewed. In a clinical study 109 patients were given barium before operation. In 81 barium was given by mouth before operation; postoperative radiography demonstrated aspiration in two cases. In 16 patients barium was introduced directly into the stomach by tube before induction of anaesthesia; one patient aspirated barium. In 12 patients it was introduced directly into the stomach after induction in such a way as to avoid oesophageal pooling of contrast medium; one of this group inhaled. In three of these four cases the most probable time of aspiration was the anaesthetic recovery phase. The lateral or semiprone position should be assumed at the time of extubation, or immediately the anaesthetic is discontinued. There was evidence that fluid, either swallowed or regurgitated, may “pool” in the oesophagus and form a potential anaesthetic hazard. The overall incidence of aspiration was 4 per cent.

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