[Prevention of aspiration syndrome in general anesthesia]

In 210 patients divided in 7 groups depending on surgical disease or pregnancy the authors estimated pH of the gastric content during the preoperative period. It was found that pH was below 2.5, i.e. the acid level of the gastric content was high enough to present a hazard for appearance of Mendelson's syndrome, should eventual regurgitation or aspiration occur during or after general anesthesia. In an effort to prevent aspiration syndrome, apart from the most reliable and well know precaution "empty stomach", the authors suggest premedication with antacid drugs before the operation. They have applied Almagel A or Cimetidin 30 min before the operative intervention. The acid level of the gastric juice was thus reduced for about 1 1/2 hours to pH levels higher than the critical 3.5, so that in the event of eventual regurgitation and aspiration the gastric content would not cause severe respiratory injury. With their suggestion for use of antacid drugs during the preoperative period the authors expand the preoperative preparation of the patient for general anesthesia with set purpose to prevent respiration (Mendelson's) syndrome.