Søreide E, Holst-Larsen H, Steen P A
Department of Anaesthesiology, Rogaland Central Hospital, Stavanger, Norway.
Acta Anaesthesiol Scand. 1994 Nov;38(8):863-8. doi: 10.1111/j.1399-6576.1994.tb04019.x.
Clinical practice and attitudes of Acid Aspiration Syndrome (AAS) prevention in connection with gynaecological and obstetric surgery were surveyed in all Norwegian departments of anaesthesia. General anaesthesia with rapid-sequence intubation using succinylcholine and cricoid pressure was the preferred method for all emergency surgery, except Caesarian section (C-section) where 58% of the departments reported use of spinal or epidural anaesthesia if time allowed for its use. Chemoprophylaxis was more often used before emergency C-section (60%) than before emergency gynaecological surgery (14%), and mostly consisted of the antacid sodium citrate given alone. Seventy-six percent of the departments used mechanical emptying of the stomach before emergency gynaecological surgery and 44% before emergency C-section. While all responders considered recent intake of a "light breakfast" in an elective patient to be a risk factor of AAS indicating delay of surgery or use of specific precautions like regional anaesthesia, rapid-sequence intubation, or chemoprophylaxis, 52-72% of the responders considered obesity, dyspepsia, recent water intake, smoking or use of chewing gum to be risk factors as well. We think this survey demonstrates a need for consensus discussions of AAS prophylaxis.
在挪威所有麻醉科对与妇产科手术相关的酸误吸综合征（AAS）预防的临床实践和态度进行了调查。除剖宫产（C 剖宫产）外，所有急诊手术首选使用琥珀酰胆碱和环状软骨按压的快速顺序诱导全身麻醉，58%的科室报告称，如果时间允许，剖宫产手术会使用脊髓或硬膜外麻醉。急诊剖宫产术前（60%）比急诊妇科手术术前（14%）更常使用化学预防，且大多单独给予抗酸剂柠檬酸钠。76%的科室在急诊妇科手术前采用胃机械排空，44%的科室在急诊剖宫产术前采用。虽然所有受访者都认为择期手术患者近期摄入“清淡早餐”是 AAS 的一个危险因素，表明需要推迟手术或采取特定预防措施，如区域麻醉、快速顺序诱导插管或化学预防，但 52% - 72%的受访者也认为肥胖、消化不良、近期饮水、吸烟或嚼口香糖也是危险因素。我们认为这项调查表明有必要就 AAS 预防进行共识讨论。
