A Feared Complication
One of the most feared complications related to surgery and anesthesia is aspiration pneumonia. This is a less common occurrence today than it was years ago thanks to the many precautions taken by anesthesia providers. This condition is brought on by aspirating gastric juices or food particles into the respiratory tract.
Defense Mechanisms
In our awake non sedated state we have several defense mechanisms that prevent any aspiration of gastric juices even if we have several defense mechanisms that prevent any aspiration of gastric juices even if we have severe heartburn or gastric reflux. The area of our vocal chords has many sensitive nerve endings and reflexes that allow immediate protection of the upper airway.
Protecting the Airway
Unfortunately, when entering the state of anesthesia most of our protective reflexes are paralyzed and our airway is left unprotected. It is up to your anesthesia provider to take over for these protective mechanisms. There are many routine precautions used to prevent any problems. The most routine of all is what is called an NPO status. A patient should have nothing by mouth except for clear liquids. Anything by mouth except for clear liquids. Anything causing the stomach to be full puts the patient at risk for reflux and aspiration. Any patient who has a history of reflux, pregnancy, obesity or a full stomach is at risk and will receive cricothyroid pressure to hopefully compress the exophagus and prevent any substance from coming into the airway. Some providers will often give medications to decrease acid in the stomach and to increase gastric motility thus empthing the stomach. Fortunately, aspiration pneumonia has become very infrequent in this setting.
