Gastrointestinal pharmacology review and anesthetic application to the combat casualty

Pulmonary aspiration of gastric content remains the number one cause of anesthetic mortality. The combat casualty due to the nature of wounds inflicted is at risk for pulmonary aspiration on induction and emergence from anesthesia. The use of gastrointestinal pharmacology agents can reduce this risk significantly. Histamine-2 receptor blocking agents Cimetidine or Ranitidine in combination with metaclopramide, which enhances LES tone, facilitate management of induction and emergence in the traumatized patient.